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Refusing to Expand Medicaid Will Cost Texas $9 Billion


by: Emily Cadik

Sun Dec 08, 2013 at 04:00 PM CST


A new study by the Commonwealth Fund, "How States Stand to Gain or Lose Federal Funds by Opting In or Out of the Medicaid Expansion," shows that Texas clearly stands to lose the most of any state. Because of Rick Perry's refusal to expand Medicaid, Texas will forego over $9 billion in federal funds while Perry holds out for a Medicaid block grant that he'll never get.

We've known all along that Texas was walking away from billions of dollars - not to mention the thousands of residents who could have been insured. But this report synthesizes data from a variety of sources to provide new estimates of what exactly the impact on each state would be.

There's more after the jump.

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Texas will lose $9.2 billion by not expanding Medicaid. That's about as much as the next three states missing out the most by opting out of the Medicaid expansion combined. The only states that would have lost more money are California and New York, and both have wisely accepted the Medicaid expansion.

According to the Commonwealth Fund report, there is not a single state that benefits or "would experience a positive flow of funds" by rejecting the Medicaid expansion. Because the federal government pays so much more of the Medicaid expansion than the states do (by a ratio of about 9 to 1), taxpayers in non-participating states still pay heavily into the expansion in other states through their federal taxes, but do not reap any of the benefits. Choosing to leave that funding on the table while still paying into it is about the worst economic decision a state could make.

Expanding Medicaid no longer means that governors are supporting Obama or even the Affordable Care Act. It means they're taking an advantage of an enormous opportunity for their states. "Even states that do not value the health and health system benefits of expanding Medicaid," the reports says, "may value the expansion as a source of funds that benefits the state economy." Sadly, Texas is one such state that does not seem to value the health of its residents.



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