As the 83rd Session of the Texas Legislature moves on, we are seeing many challenges being presented surrounding the state's priorities of Public Education, Health Care, Water, and Transportation. We have seen, heard and written much about each of these in this report, and I would like to share various discussions I have had with the Texas Public Policy Foundation (TPPF) on the Medicaid Challenges facing Texas. I think you will appreciate these findings from TPPF and see them as both informative and certainly revealing.
Medicaid Facts that We Know
- State spending on Medicaid currently accounts for 25% of the 2012-13 state budget (General Revenue) and is projected to be $28.6 billion in the 2014-15 biennium. Under expansion, GR spending on Medicaid would comprise 33% of the budget, or $160.4 billion, by 2040.
- The total (All Funds) budget for the 2014-15 biennium is projected to be $190 billion. Of this, about $70 billion will go to fund Medicaid-roughly 37%!
- According to the Congressional Budget Office, federal spending on Medicaid will more than double over the next decade, increasing from $265 billion to $572 billion.
Increasing the number of people on Medicaid will decrease their access to Medicaid providers. Currently, 70% of Texas physicians will not accept new Medicaid patients, leaving enrollees with inadequate access to primary care. As a result, they often seek care in hospital emergency rooms, driving up uncompensated care costs. Last year, uncompensated care costs totaled about $5 billion; under expansion, that total would likely increase as Medicaid patients are forced to seek care in hospitals.
Many Believe the Best Solution for Texas
The time has come for comprehensive, fundamental reform of our Medicaid system. Medicaid enrollees should not be asked to remain in a program that gives them increasingly poor access to health care. I continue to believe that States, not the federal government, are best suited to design and implement flexible, managed-care programs that will control costs and improve outcomes.
- The Texas Legislature is at the beginning of a process that will end with Texas continuing to provide leadership to the nation on Medicaid reform.
- House Republicans are instigating a serious public discussion about the best way to improve Medicaid and provide affordable, accessible healthcare to the most vulnerable Texans.
- The best solution calls for the flexibility of a market-driven, managed care components and we believe the final product will accomplish these goals.
Medicaid Expansion Opposition and Texas Solutions
As always I agree that what is best is to implement a Texas-based solution that charts a path of limited government, individual freedom and personal responsibility.
In rejecting expansion, we will choose a sound fiscal policy over empty promises to Texas taxpayers. Simply put, expansion is not a solution for improving health care for the residents of the State of Texas.
Medicaid expansion will trap millions more in Medicaid's fundamentally flawed system. It is reckless and irresponsible to expand the current Medicaid program because it is unsustainable.
Those advocating expansion are attempting to get Texas taxpayers hooked on the lure of "free money" from the federal government. With the national debate surrounding sequestration, spending, and the nation's $16 trillion of debt, I believe it would be irresponsible for Texas to expand our current program. It is uncertain as to whether the federal government will be able to deliver on the matching funds that it is promising over the long term and perhaps not even over the short term.
The bottom line is I agree it would be shortsighted and irresponsible for Texas to expand our current Medicaid program, given the history of the current Washington Administration and their failed promises especially with the fiscal crisis the nation finds itself.
I am very grateful to my friends at Texas Public Policy Foundation for their insightful research and wisdom as they provide solid factual information for citizens and legislatures to be able to fully understand issues.
It remains my pleasure and honor to represent all the people of House District 2. My staff and I continue to welcome your input and your questions. You can contact our office; mailing address: P. O. Box 2910, Austin, TX 78768. Email: District2.Flynn@house.state.tx.us. Toll free number 1-800-734-9515.
May God continue to bless you and the Great State of Texas!
Dan Flynn, State Representative, District 2