Texas may be challenging federal health care reform in court, but state lawmakers are still monitoring how the law will affect costs and care in Texas.

The massive health care act has been a political football since it was first introduced in 2009. Texas is one of the plaintiffs in a lawsuit asking the U.S. Supreme Court to overturn it.

Audio: Ben Philpott's story for KUT News

At a hearing at the state Capitol on Monday, state Rep. Lois Kolkhorst, chairwoman of the house Public Health Committee, told lawmakers to keep their political opinions at bay — and even forbade the use of the term “Obamacare” in reference to the act.

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“While there are issues on both sides, I'd like today not to politicize this, but rather to traverse this very carefully,” said Kolkhorst, R-Brenham.

The public hearing started with about 90 minutes of projections from economist Thomas Saving of Texas A&M University, who told lawmakers that the reforms would eat up the federal budget, forcing Washington to push more Medicaid costs to the states.

“The state's share of Medicaid was about 34 percent in 2010, and it's going to be almost getting up near 40 percent,” Saving said. “It's going to increase significantly.”

Some Democrats questioned Saving’s findings. They asked whether he had factored in any cost savings for additional preventative care. Saving said preventative care never pays.

“The fact that you've gone in, had a mammogram and know that you don't have a problem, they don't value that,” Saving said. “Preventative stuff does not reduce costs for the third-party payer. Almost every study would say that.”

Lawmakers also heard how full implementation of the law could affect the state's large uninsured population. Billy Millwee of the Texas Health and Human Services Commission said that under the federal law, the amount of uninsured Texans would drop from 26 percent to 9 percent.

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“Some of those will be undocumented. The individual mandate or the availability of the subsidy just won't be there,” Millwee said. “You'll have some people who just won't comply. Because the penalty, in a cost benefit analysis, it may still be cheaper to not get insurance then it is to get insurance.”

The Texas Legislature won't meet again until January 2013. Updates on how implementation of the law could affect the state's tight budget will be vital as budget writers figure out how to pay the bills.

The U.S. Supreme Court will hear oral arguments in the case on March 26-28. The six hours of arguments will combine several lawsuits asking the court to overturn the law.

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