Expanding Medicaid to cover poor adults is incredibly unpopular among most Texas Republicans — and Gov. Rick Perry has vowed the key tenet of the federal Affordable Care Act won't be rolled out here. But proposals to do it have gained traction among some fiscal conservatives, who argue the economic benefits of expanding Medicaid could outweigh the political backlash.
This interactive map shows the estimated economic impact of expanding Medicaid by legislative district, according to a report by Billy Hamilton, the state’s former chief revenue estimator and a consultant commissioned by the interfaith group Texas Impact and Methodist Healthcare Ministries. To distinguish partisan leadership in each district, Republican-led districts are covered by red stripes and Democrat-led districts by blue dots. Switch between the maps to see the anticipated economic impact of the Medicaid expansion on House and Senate districts.
Economic Impact of Medicaid Expansion by:
Texas could draw down $100 billion in federal funds over ten years if the state invests $15 billion to expand Medicaid services to impoverished adults, according to Hamilton’s report “Expanding Medicaid in Texas: Smart, Affordable and Fair.” The infusion of federal funding would stimulate local economies, resulting in $2.1 billion in new local tax revenue, Hamilton, a former deputy state comptroller, suggests.
In both legislative chambers, Republican districts had lower annual uncompensated care costs on average and greater estimated increases in local tax revenue than Democratic districts, according to Hamilton’s findings. The district represented by Sen. Ken Paxton, R-McKinney, has the greatest estimated increase in local tax revenue according to Hamilton's findings — nearly $85 million between 2014 and 2017.
Use this Tribune interactive to see uncompensated care costs by county.
Opponents of the Medicaid expansion argue following provisions in federal health reform is a slippery slope to socialized medicine. They suggest problems in the existing Medicaid program would be exacerbated if 2 million additional Texans were enrolled. For example, the low provider reimbursement rates paid by Medicaid have created a limited network of available clinicians; if the program expands, they argue existing Medicaid patients — like children, pregnant women and the disabled — could have greater difficulty accessing care.