Selling Out Texans: The Costs of Rejecting Medicaid Expansion

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Credit: AP Photo|Politico

Credit: AP Photo|Politico

1 million Texans, or 1 in 4 non-elderly adults, are unnecessarily uninsured. Mostly working, childless adults, the uninsured in Texas are struggling to maintain their health with no means to pay for care. If Texas accepted Medicaid expansion, the majority of these low-income adults would have access to affordable health care, and the Federal government would cover no less than 90% of the bill. But Texas isn’t buying.

As part of the politically divisive Affordable Care Act, Medicaid expansion offers Republican legislators the option to symbolically reject a portion of a bill that they, and influential Tea Party constituents, vehemently abhor.

What is this costing Texans? In the next ten years, approximately 90,000 lives and $90 billion dollars. Texas currently spends $1 billion in local taxes for care for the uninsured, and privately insured Texans each pay, on average, $1,800 more each year in premiums to cover $5.5 billion in annual uncompensated hospital care. Medicaid expansion would transform this landscape. An independent analysis revealed Medicaid expansion would improve community health and increase state revenue $1.29 for each $1 spend on expansion. Yes, Texas would make money by expanding Medicaid.

Stakeholders across Texas are increasingly frustrated by rejection of Medicaid expansion in Texas. Bill Hammond, CEO of The Texas Association of Business, noted to NPR that Texans already are paying for Medicaid expansion through federal taxes. “It’s our money we are sending to Washington… [and] we are not getting it back.” A coalition of diverse health organizations agrees, and has been advocating for expansion under the banner “Texas Left Me Out.” For the betterment of the insured and uninsured, Texas should expand Medicaid. But while it remains politically divisive, Medicaid expansion in Texas is dead on arrival.


Infographic: A 50-State Look at Medicaid Expansion by Families USA

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2 Responses to “Selling Out Texans: The Costs of Rejecting Medicaid Expansion”

  1. mjschleiff Says:

    Thanks for a very interesting post here! My home state of West Virginia did elect to expand Medicaid, and, while it is opening up new possibilities for a number of formerly uninsured people, a whole cascade of challenges (health worker capacity, willingness of practitioners to see many additional Medicaid patients, etc.) are now following. I certainly think it is a good step, but it is also a complex step and, in some ways, WV wasn’t “ready” (is anyone ever truly ready for this kind of change??).

  2. careysharpe Says:

    It seems there are unintended consequences of all government initiatives, and there are legitimate reasons why Republicans reject some of these expansions of already huge government programs. While I agree that if the money is available to the state, they should consider taking it, I can understand the hesitancy to do so in an effort to restrain the federal government’s involvement (and the mandates that come with it) in state-run health care programs.

    Medicaid reimbursement rates are far below private insurance rates, and significantly less than Medicare reimbursement rates. Adding additional patients to these plans and expecting hospitals and physicians to see these patients without appropriate reimbursement for services is unrealistic. Currently 38% of physicians already refuse to see or limit their numbers of Medicaid patients. What good is having Medicare coverage if no providers are willing to actually see these patients?

    If the expansion of Medicaid follows the path of past government healthcare programs, costs will skyrocket out of control. Ultimately the expansion does not solve the root issue of our health care problem in the U.S. as it does not address bringing down health care costs overall. We need better means of health insurance portability and tort reform, in addition to patient transparency into the actual costs of their health care services up front. Health care is the only thing we purchase in this country where we often have no clue how much we are spending until several months later when a bill comes in the mail! Better informed health care consumers will allow for competition in the health marketplace, and will help lower the actual costs of these services making health care more accessible to all.

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