Perry Opting Out of Medicaid Expansion: What Texas Stands to Lose

by: Emily Cadik

Mon Jul 23, 2012 at 10:00 AM CDT

Despite the 4.5 million Texans insured through Medicaid who otherwise would not be able to afford coverage, Perry recently stated that adding people to Medicaid is like "adding people to the Titanic."  Accordingly, he's limiting Medicaid expansion in Texas - an expansion that would have been required as part of the ACA, but is now optional.  And the price paid for all the posturing is that a lot of people who could stand to benefit tremendously from the ACA now won't. Politico reports: "Perry's decision means as many as 1.3 million people who could have gained coverage under the Medicaid expansion won't get it, according to figures from the Urban Institute. That's more than any other state that has given a definite 'no' to the Medicaid expansion, including Florida."

The chart below, courtesy of the Washington Post, shows that Texas has some of the most to gain from the ACA.  Currently only families under about 30 percent of the federal poverty line are covered by Medicaid - a fact that will fortunately remain unchanged despite Perry's feelings about Medicaid.  It's also fortunate that families between 100 and 133 percent of the poverty line will now be eligible for subsidies to buy a private plan, again regardless of Perry.  But families between 22 percent and 100 percent of the poverty line in Texas - families who were supposed to receive Medicaid - will receive neither Medicaid nor subsidies to help them purchase insurance.  Because they were supposed to receive Medicaid, the subsidies were never allocated for them.  

And we'll still be footing the bill for other states to benefit from changes to Medicaid, in addition to other costs associated with leaving this group of people uninsured.  Leticia Van De Putte, in her op-ed "Fed Up with Perry's Political Grandstanding about Medicaid", explains: "Not only will Texas taxpayers foot those emergency room bills here, but by giving up federal funding that would come with the expansion, we'll also send even more tax money to pay for expansion in other states."

This news comes at a time when poverty levels are expected to hit a level not seen in fifty years: "The official poverty rate will rise from 15.1 percent in 2010, climbing as high as 15.7 percent. Several predicted a more modest gain, but even a 0.1 percentage point increase would put poverty at the highest since 1965." With more and more people falling below the poverty line, it's clear that our governor has no intention to take advantage of any available options - even ones we're already paying into - to help out.