Medicaid expansion would give Texas a jolt
Texas could reduce the price of health care and boost the economy if only we could find some compassion for the poor.
Countless studies show people with health coverage who routinely visit a primary care physician have lower health care costs. Insured people are also less likely to let a problem become a crisis and end up in an emergency department. They do not run up huge bills that go unpaid.
When doctors and hospitals get stuck with unpaid bills, they charge other patients higher prices to cover their losses. Gall bladder surgeries will be cheaper if fast-food workers can see a nurse for the flu rather than end up with colossal ER bills.
Yet our Republican-led Texas lawmakers worry about appearing too generous toward impoverished people, who mostly do not vote for them. For a decade now, leaders like Gov. Greg Abbott and Lt. Gov. Dan Patrick have rejected attempts to expand coverage
Expanding Medicaid would boost the economy and the quality of life for 1.4 million Texans while lowering health care costs for all.
for the needy and working poor.
Unsurprisingly, Texas has the highest uninsured rate in the nation at 18.4 percent, compared to Massachusetts with only 3 percent. Texas ranks 50th in the country for access to care, and highest for people delaying treatment due to cost, according to the UnitedHealth Foundation’s annual rankings.
Three-quarters of the uninsured would like coverage, but they cannot afford it because Texas rejected federal Medicaid subsidies. Meanwhile, other states such as Arkansas expanded Medicaid coverage for the uninsured and saw a 6 percent drop in the fatality rate among adults ages 20 to 64, a University of Chicago study proved.
Abbott, Patrick and fellow Republican lawmakers could reduce our workforce death rate by 6 percent if they agreed to
accept $5.4 billion in annual federal funding. Employers could experience lower absenteeism due to illness if their workers could routinely see a doctor.
Expanding Medicaid would boost the economy and the quality of life for
1.4 million Texans while lowering health care costs for all.
Texas’ leaders want to do the opposite. Attorney General Ken Paxton is leading the effort to take coverage away from the millions of Texas enrolled in the Affordable Care Act by asking the U.S. Supreme Court to declare Obamacare unconstitutional.
If the court rules in Paxton’s favor, 20 million more Americans will lose coverage and drive up health care costs for everyone.
Meanwhile, the Biden administration is trying to expand the Affordable Care Act with measures welcomed by both doctors and financial markets.
“Opening the ACA exchanges provides a crucial lifeline at a time when people are losing insurance because of job layoffs as a result of the pandemic,” the American Medical Association said in a statement.
“We also applaud the Administration’s move to eliminate barriers to Medicaid enrollment, which will repair holes in the health care safety net.”
Fitch Ratings, a bond rating firm also owned by the Hearst Corporation, said expanding coverage would boost not-for-profit hospitals that have struggled due to unpaid bills and COVID-19 costs.
“The Biden administration is expected to focus on reducing the number of those who are uninsured by … encouraging the 12 states that have not expanded Medicaid under the ACA to adopt expanded coverage,” Fitch analysts wrote. “This latter change would be credit-positive for hospitals in states where Medicaid has not been expanded, although political headwinds in key states like Texas persist.”
A nonpartisan group called Texas 2036, led by President George W. Bush’s former Secretary of Education Margaret Spellings, has launched a website where visitors can understand the costs and benefits of more than 500 possible health care policy decisions using a database.
Fully expanding Medicaid in 2025 to cover 846,000 people would cost the state an annual premium of $55.60 per person a year, according to the model. If Texas set up its own ACA Exchange, rather than rely on HealthCare.gov, the cost drops to $36.00 per person.
Make a few more tweaks, and the state’s cost drops even further. The program does not calculate the potential increase in state revenue from a healthier population growing the economy faster. Economic forecasting experts at the Perryman Group ran those numbers.
“The net total dynamic fiscal benefits during the 2022-23 biennium would include $2.5 billion to the state and nearly $2.0 billion to local government entities across Texas,” veteran Texas economist Ray Perryman concluded. “For every $1 of non-federal funds invested, $1.95 is returned to the state in dynamic tax revenue.”
Texas should expand Medicaid out of simple human decency. But the economic case for expansion is even more compelling. If only Texas’ top leaders would put Texans first instead of sticking to an outmoded way of thinking.