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More arguing over health care costs

There are many things to say about this.

The debate over how much federal health care reform will cost Texas put the state’s health and human services chief on the defensive on Wednesday, as he presented a budget estimate to lawmakers that is 20 times higher than federal projections and questioned the mathematics education of an influential U.S. House chairman.

HHSC Commissioner Tom Suehs estimates that health care reform’s top-dollar items — Medicaid expansion to roughly 2.1 million Texans, plus heightened reimbursement rates for primary care physicians — will cost the state more than $27 billion between 2014 and 2024, up $3 billion from his most recent estimate.

But the Congressional Budget Office’s numbers are far different. Between 2010 and 2019, the agency estimates, the reform will cost Texas $1.4 billion. A letter written last month by U.S. Rep. Henry Waxman, D-California, the chairman of the House Energy and Commerce Committee, notes that Texas’ estimate is more than the $20 billion the reform is expected to cost all state governments combined in the next decade.

“I don’t know where he went to school and got his math education. But it’s not right,” Suehs said of Waxman, speaking at a joint hearing of the Senate Health and Human Services and State Affairs committees. (The answer? UCLA.) “I can’t rationalize the CBO’s budget numbers when I know that I’ve got a higher population of uninsured than most states have total population.”

Where to begin?

1. With all due respect to Tom Suehs, who deserves credit for his handling of the food stamp fiasco as well as for admitting that the Affordable Care Act will also lead to many cost reductions for Texas, I’ll take the CBO’s numbers over his any day.

2. As State Sen. Eliot Shapleigh said, it’s quite odd for the Lege to be looking at budget projections that begin four years out from now. The earliest the Lege will have to deal with the actual effects of the Medicaid changes is likely to be 2013, with the bulk of it beginning in 2015; as Sen. Shapleigh also noted, about 85% of the cost Suehs is projecting doesn’t start accruing till 2017. The 2011 Lege, which has to deal with a budget deficit, school finance, and oh yeah, redistricting, can put it off for now. I’m not saying that we shouldn’t be looking ahead to the future, but a lot of people who are in the Lege now – including Sen. Shapleigh – won’t be there in 2013 or later. A very different cast of characters, and not just in the Lege, will be making the actual decisions about how to deal with all this. And the odds are, the Medicaid stuff that Suehs is fretting over will have been revised again by that time.

3. Something that always seems to get overlooked in all these discussions is that whatever amount of extra money Texas winds up spending on health care, that money will be spent on making many people’s lives better and healthier. That’s something we should have been doing all along but are just now being forced to do because things like cutting Dan Patrick’s property taxes have been considered a higher priority.

4. Finally, even if the state hasn’t been paying for these health care expenses, that doesn’t mean no one has. Ask your county hospital district administrator what will be the effect of having millions more people on any form of health insurance, be it Medicaid or something else, and see what he or she has to say. What the ACA will do, among many other things, is spread that burden around more equitably. Which is just fine by me. The DMN has more.

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  1. […] Tom Suehs up through Governor Perry have been claiming that the Affordable Care Act will cost the state of Texas a lot more than the CBO estimates. There’s quite a bit of evidence to suggest that the state is wrong on […]

  2. […] put aside for a second the fact that his figures are alarmist and highly misleading. Dewhurst is fretting about $27 billion over a decade. That’s $2.7 […]