LBB calls for expanding Medicaid

From the Quorum Report:


It’s constitutional – deal with it

The recommendation given to the Article II Senate Finance workgroup notes that $50.4 million in state funding would draw down $4 billion in federal match for the next budget cycle

The Legislative Budget Board has included funding to extend Medicaid coverage to low-income adults as part of its list of priorities for additional funding to SB 1, the Senate budget bill.

The state’s political leadership has balked so far at endorsing the program’s expansion, which is a central component of the federal Affordable Care Act. The LBB recommendation, though, stems directly from the size of the federal match and the resultant outsized return on investment for the state.

Or to put it another way, the LBB is acknowledging just how much cash would be left on the table should the state’s leadership ultimately decide against the expansion. Also, the added coverage is expected to drive down governmental health care costs at the local level as fewer people seek care in hospital emergency rooms. Uncompensated care at hospitals amounted to $3.1 billion in 2011, according to LBB figures.

The federal government would cover 100 percent of the cost of coverage for the 2014-15 state budget cycle. Meanwhile, the cost to the state would be $50.4 million to cover half of the administrative costs of the expansion. In turn, the federal aid over the next two fiscal years for the expansion is expected to be $4 billion, according to the LBB. In other words, the state in its next budget would bear 1.2 percent of the total cost of the expansion.

The state’s share could actually be less than that. The LBB earlier recommended allowing the local taxing authorities that bear the biggest burden of paying for uncompensated care provided by hospitals to cover the match.

Burka thinks that freshman Republicans will be happy to hear this, because it means they won’t have to “[tell] their hometown doctors, hospitals, nursing homes, and other healthcare providers to go fly a kite”. I don’t know where he derives that conclusion, as it seems completely out of character for them. Take a look at this Tribune overview of the new legislators and tell me if you see any inclination towards that finding any kind of solution for Texas’ shameful lack of health care access. It’s one statement after another about what they oppose – abortion, “big government”, regulations, and taxes – and the only mentions of health care at all are in the context of opposing Obamacare. I really don’t understand what he’s thinking. Be that as it may, the bottom line continues to be that by any rational evaluation, this is a no-brainer. The only reasons Rick Perry and his legislative cronies have to oppose Medicaid expansion are political zealotry and a deep indifference to the needs of millions of people. EoW has more.

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