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Texas Braces for Medicaid Status Quo

John Commins, for HealthLeaders Media, June 5, 2013

As a result, when Jan. 1, 2014 rolls up, "the poorest Texans will be left out," says Anne Dunkelberg, associate director of the nonprofit Center for Public Policy Priorities.

"If they live in a big city they might be able to get some help from their local hospital district and what group gets served depends on what city they live in. That is going to be funded by 100% local property tax dollars instead of 100% federal funds. And if they live in a more rural county they may have no options. There may be no public program that is going to help them."

Dunkelberg says various studies have estimated that Texas will lose about $6 billion [PDF] a year over the next decade and beyond in federal subsidies because it won't expand the Medicaid rolls. "The funds would have created hundreds of thousands of jobs, the estimates ranged from between 215,000 to 300,000 jobs a year," Dunkelberg says.  

"The amounts of money that are potentially going through communities—urban and rural—are fairly staggering and potentially having a big boost in terms of economic development in some parts of the state and certainly offsetting large amounts of uncompensated care that is currently funded with local property tax dollars. We are leaving that money on the table."  

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6 comments on "Texas Braces for Medicaid Status Quo"


Thomas Dodson (6/7/2013 at 1:26 PM)
How can Texas, or any other state for that matter, pass on billions of funds designed to help the most vulnerable among us? Short-sighted leadership is an understatement when describing their leadership.

Phyllis Kritek (6/6/2013 at 1:15 PM)
It is at least worth noting here that while arguments proceed shaped by politically motivated ideological purity or economic self interest "the least among" Texas citizens will suffer from lack of health care. The chronicling of challenges ACA presents might be energy better invested in creative problem solving. Some states are doing just that.

Pete Kelley, MD (6/6/2013 at 12:13 AM)
The carrot and stick at the same time. Medicaid expansion is not the answer. As a pediatric surgeon, I have witnessed the financial impact of Medicaid expansion first hand, through the SCHIP's program. Not only do the uninsured get enrolled, but a number of previously insured patients also convert to Medicaid. In Tennessee, we no longer have "self-pay", uninsured children, however, 65% of the children in the state are now covered by TennCare. The reimbursement rates are significantly below Medicare rates, and the system is run by Medicaid MCO's who make a huge profit by throwing up administrative hurdles and denying claims. The financial impact on pediatric specialists has been incapacitating. The hospitals are doing okay, but the doctors are getting destroyed.