This Is What Texas Stands to Spend, and Gain, with Obamacare
Governor Rick Perry vows that the Medicaid expansion prescribed under Obamacare won't come to Texas, the state with the highest rate of uninsured in the country. He fears it would render Lone Star State health care a mere "appendage" of the federal government.
The feds, of course, would pick up nearly all of the tab on new Medicaid enrollees, who aren't patrons of any health care system, Lone Star or otherwise, unless you count ER visits and uncompensated care. Ultimately, lawmakers will make the call on whether to expand Medicaid to cover some 2,359,000 additional Texans.
That comes to 300,000 uninsured Dallas County residents covered. So, Texans should know how much it all costs, with the expansion, without the expansion, and without the Affordable Care Act at all. Thankfully, the nonpartisan Kaiser Family Foundation put together a state-by-state analysis.
Because nearly a quarter of Texas' population is uninsured, we stand to gain the most -- but it'll cost. To give you an idea how much, Texas would spend roughly $159 billion on Medicaid between 2013 and 2022 without Obamacare. If neither Texas nor any other state expands Medicaid, Texas would spend about $163 billion over the same period -- a 2.5 percent increase from baseline levels.
If Texas chooses to implement the Medicaid expansion, we would spend nearly $169 billion between 2013 and 2022 -- a 6.1 percent increase from baseline spending. That is what we pay.
What we get is a $1.7 billion reduction in medical bills uninsured Texans don't pay over the same period. With the Medicaid expansion, some 2,359,000 uninsured Texans get covered. Without it, we get only an additional 550,000 covered. And in the absence of Obamacare, 7,355,000 Texans remain one health crisis away from insolvency.
It's worth noting that the Kaiser study didn't have the data to evaluate other factors that could result in gains for Texas. For example, it doesn't account for impoverished and medically needy adults who would qualify for Medicaid with or without the expansion. The feds would cover most of that cost, taking the burden off of the state. Nor does it account for additional revenue resulting from increased federal expenditures.
Texas Tribune put together a nifty, interactive map using Kaiser data.