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.
Paul Burka, senior executive editor of Texas Monthly, commented about this development on his blog the next day :
“Three guesses who is turning backflips at this news. It’s the freshman Republicans, who were facing the prospect of (a) voting for a $7 billion spending bill or (b) telling their hometown doctors, hospitals, nursing homes, and other healthcare providers to go fly a kite.
“This is a no-brainer. The federal government would cover 100 percent of the cost of coverage for the 2014-2015 budget cycle. The state would have to put up $50.4 million to cover half of the administrative costs of the expansion. In return, the federal aid over the next two fiscal years would be $4 billion, according to the LBB. The state in its next budget would bear just 1.2 percent of the cost of the expansion.
“This would bring to an end a shameful era in which the state’s leaders did absolutely nothing to help people without health insurance and sent them instead to hospital emergency rooms, the most expensive care there is. This is the way the Legislature has handled health care for decades, under D’s and R’s alike. It was a hidden tax increase on property owners that pushed the cost onto local taxpayers instead of state taxpayers.”
Gilmer and Upshur County have already gone through a recent era in which there was no hospital here. Zealous adherence to ideology may well cause another wave of rural hospital closings unless more pragmatic voices prevail in the health care financing debate.