The White House is starting to seriously guilt trip the states that didn't expand Medicaid – and rightly so. Last week the White House Council of Economic Advisers released a report called “Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid.”
According to the report, in the 26 states that have expanded Medicaid, 5.2 million people have gained Medicaid or Children's Health Insurance Program (CHIP) coverage. In the 24 states (including Texas) that have not expanded Medicaid, 5.7 million people have been denied this opportunity.
But the impacts go far beyond the already serious loss of so many people not having health insurance. “While one important goal of the Medicaid program is to ensure that enrollees have access to medical care,” the report says, “an equally important goal is to protect families from large out?of?pocket medical costs and ensure that illness does not threaten families' ability to meet other important needs.” And beyond that, there are enormous economic impacts.
If Rick Perry accepted a Medicaid expansion, Texas would be able to insure 1,208,000 more people. This would translate into:
- 3,262,000 more physician visits each year,
- 176,000 more cholesterol screenings,
- 44,100 more mammograms,
- 75,200 more pap smears,
- 161,000 more people reporting good, very good or excellent health,
- 54,100 fewer people with catastrophic out-of-pocket medical costs per year,
- 171,800 fewer people forced to borrow money or skipping payments due to medical bills, and
- 97,000 fewer cases of depression.
Even for those who aren't persuaded by the prospect of a healthier state might be convinced by the economic impacts.
Expanding Medicaid would create 59,400 jobs in Texas over the 2014 – 2017 period and bring in $13.7 billion in federal spending. On top of that, expanding Medicaid would increase the state GDP by $3.1 billion in 2014 alone and $10.42 billion over the next three years.
“Healthier workers who are less financially stressed and in better mental health may be more likely to participate in the workforce or have higher productivity on the job, economic benefits that could be important over the long run. More immediately, States that fail to expand Medicaid are also passing up billions of federal dollars that could boost their economies today,” the report states. “By increasing low?income individuals' ability to access care, relieving cash?strapped families of high out-of-pocket costs, and reducing uncompensated care, the expansion in insurance coverage enabled by those federal dollars would boost demand for medical and non-medical goods and services. Over the next few years, while the recovery from the 2007 – 2009 recession remains incomplete and slack remains in the economy, this increase in demand would boost overall employment and economic activity.”
Rick Perry and his allies have made their point that they don't like Obamacare. But continuing to thumb their noses at it is getting very expensive.