1.5 million low-income Texans may go without health care coverage after lawmakers in the state voted against expanding Medicaid using $100 billion in federal funds offered under President Obama’s health care law. The decision comes almost a year after the Supreme Court ruled that the federal government cannot require states to enroll more Medicaid beneficiaries.
The proposal, sent to Gov. Rick Perry (R) on Sunday, says state health officials “may only provide medical assistance to a person who would have been otherwise eligible for medical assistance or for whom federal matching funds were available under the eligibility criteria for medical assistance in effect on December 31, 2013.”
Under the Affordable Care Act, the federal government fully funds Medicaid expansion until 2016 and gradually reduces its contribution to 90 percent in 2020 and subsequent years. Texas — which has the highest percentage of uninsured residents — would never pay more than 7 percent of the cost of providing coverage to Texans, but Texas Republicans argued that “even $1 in the name of ‘Obamacare’ was a dollar too much.”
“Texas will not be held hostage by the Obama administration’s attempt to force us into this fool’s errand of adding more than a million Texans to a broken system,” Perry said. The decision means a loss of approximately $7 billion for Texas hospitals, which comes on top of the $700 million a year reduction in Medicaid payments from state budget shortfalls and cuts under sequestration.
Low-income Texans will also continue to struggle to afford coverage, since the law does not offer federal tax credits to purchase private health insurance coverage for most people below the poverty line. People living in the 26 states that have refused to expand Medicaid and have incomes “from the poverty level up to four times that amount ($11,490 to $45,960 a year for an individual) can get federal tax credits.”
Tom Banning, chief executive officer of the Texas Academy of Family Physicians, told NPR that failing to expand Medicaid will only shift costs throughout the health care system.
“These people don’t choose to get sick. When they do, they’re going to access our health care system at the most inefficient and expensive point, which is the emergency room,” Banning says. “And it’s going to cost the taxpayers, and it’s going to cost employers a lot of money to care for them. And we’re going to be forgoing billions of dollars that the feds have set aside for the state to pay for and provide this care.”
As a result of the state’s decision, Texas will continue paying for the taxes that pay for Medicaid expansion but wil be sending those dollars (and benefits) to other states.