The refrain we keep hearing from Perry and company is that Texas just doesn't need a Medicaid expansion – we don't have much to gain and we already have a solid health care network. But as it turns out, the state has basically been taking federal money away from state-run hospitals and using it to fill its own budget shortfalls.
According to the Houston Chronicle:
Texas is diverting millions of dollars of federal money intended to reimburse three state-owned hospitals for uninsured care and shortfalls in Medicaid payments, University of Texas officials say. That money, which is rerouted into a general fund, otherwise would offset expenses that the University of Texas Medical Branch, M.D. Anderson and UT Tyler incur providing care for the uninsured…
The intent of the federal programs is for the state and federal governments to repay the hospitals, but Texas contributes no money and instead forces the state hospitals to provide the state's contribution, then takes the federal contribution for the general fund. The hospitals are never compensated for the cost of caring for the uninsured and for shortfalls in Medicaid payments, according to officials at UTMB, UT Tyler and the Texas Health and Human Services Commission.
Failure to reimburse hospitals means they can serve fewer uninsured patients. They're turning people away that they're supposed to be able to help, and are even receiving money to help.
And it keeps getting worse. For instance, according to the Texas Observer:
In 2011, UTMB denied 91 percent of uninsured Texans seeking medical care, according to a new report from a nonprofit coalition advocating for Galveston County's uninsured residents. That's a sharp increase; in 2005, UTMB turned away just 35 percent of uninsured people seeking care.
Unfortunately, taking the funding for the uninsured for other purposes has been the legislature's band-aid for budget issues since 1986. Rick Peters, bureau chief of the former Texas Department of Health, now the Department of Health Services, from 1986 to 1999, says, “That's how that budget crisis got solved… That freed up a bunch of money to be rolled back to the general fund.”
Expanding Medicaid would insure millions of additional Texans – Texans who are more and more often being turned away by hospitals. But according to the Governor, Senator Cruz, Senator Cornyn and many in the Texas legislature, our state doesn't really need it.