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The Cost Of Not Expanding Medicaid

Ryan Poppe
Texas Public Radio

Texas Matters: A new study by the RAND corporation is examining the economic costs of states who do not expand Medicaid coverage under the Affordable Care Act. Also in this episode: Texas voter turnout hits last in the nation in 2010, and how recovery efforts are going in West, Texas.

To expand or not to expand Medicaid, that is the question

Health care advocates and business groups were disappointed at the conclusion of the last legislative session. Their efforts failed to convince Gov. Rick Perry and the majority of Texas lawmakers to expand the state’s Medicaid population under the Affordable Care Act.

Had Medicaid expansion been enacted during the legislative session that wrapped up at the end of May, individuals earning up to about $15,000 a year or for a family of four earning up to $31,000 a year would have been eligible for Medicaid health coverage beginning in 2014.

The federal government would have paid the entire cost of Texas’s expansion for the first three years through 2016, and 90 percent in years thereafter.

Texas is not the only state rejecting the health care expansion--many other states in the South, are also telling Washington D.C. they don’t want it. According to a new RAND Corporation study those states will foot the bills for the cost of treating uninsured residents.

Carter Price is the study's lead author and a mathematician at the RAND corporation, a nonprofit non-partisan research organization.

"States currently spend money on uncompensated care costs so when someone goes to the hospital but they don't have health insurance the state governments and local governments--through a variety of mechanisms--wind up paying for a portion of that. So when you increase the number of people insured, when those people show up to the emergency room, or they show up to get medical care, they have insurance and so the state doesn't have to spend money covering for the care in some fashion."

At the time of the analysis there were 14 state whose governors had stated that they would not expand Medicaid. Price said that if more states elect to expand Medicaid then the RAND numbers would be lower because more people would be insured and states wouldn't have to cover costs of taking care of those uninsured people on their own.

"Beginning in 2017 states will be responsible for paying some of the cost associated with Medicaid expansion, so while there aren't significant budgetary effects on states in the first three years--so between 2014-2016--eventually the state will be picking up a portion of that cost. So there may be budgetary, fiscal reasons why a state may not want to, but certainly from an economic standpoint, more federal dollars will flow into those states that expand Medicaid and that will benefit the economies of those states."

Also on this edition of Texas Matters:

Credit Chris Eudaily / TPR
Texas Public Radio
Even with a convenience of early voting, turnout is still low in Texas.

What will it take to get people in Texas to vote?

Texans aren't showing it if they are unsatisfied with how things turned out in the last legislative session, or if they are fed up with how their congressman is performing in D.C.

The Lone Star State was last when it came to voter participation in 2010 according to a study by the Annette Strauss Institute for Civic Life at the University of Texas at Austin.

Regina Lawrence is the director of the institute.

"We talk about in the report that there are a number of likely reasons for the low political participation here, and yes, one of those likely reasons is the we have fairly non-competitive elections here. Many of the statewide races have not been competitive. As you know, a democrat hasn't won in Texas--a statewide race--since the early 1990s. What happens there is that voter interest in the campaign and media interest in the campaigns can be depressed and that's true for folks who might lean Democratic, it's also true for those who might lean Republican. In other words, when it's not a closely contested race, there's less incentive for anybody to really pay attention or stay involved."

Has West, Texas been forgotten?

On April 17 an ammonium nitrate explosion at the West Fertilizer Company tore through the Texas town of West. The blast and fire killed 15 people and over 200 homes were destroyed including the middle and high school.

It was a major national story and there was a surge of support from across the nation, but that was about two months ago. The people of West are wondering if they’ve been forgotten as they work on the long term recovery.

Karen Bernsen is the director of the West Long Term Recovery Center. Click here to find them on Facebook.

"I've learned a new term, 'donor fatigue.' To me that doesn't really sound appropriate, it's more like 'donor distraction' because there's so many other avenues for people to send their donation and the need here is still very great."

*You can make a donation to the West Long Term Recovery Center at: westltr.org

David Martin Davies can be reached at dmdavies@tpr.org and on Twitter at @DavidMartinDavi