Texas Republicans continue to posture against expanding Medicaid under the Affordable Care Act as lobby groups prepare to press legislators on the merits of taking billions in federal money.
Perryman said the Medicaid system and Affordable Care Act are not perfect, but that under the framework, the best option for the state from an economic perspective is participating in the expansion.
The analysis by The Perryman Group showed that every $1 spent by the state to expand Medicaid returns $1.29 in revenue during the first 10 years of expansion.
Perryman said Medicaid spending leads to economic activity, federal funds inflow, reduction in costs for uncompensated care and insurance, and enhanced productivity from a healthier population.
The gains or losses would be multiplied for Tyler because it is a regional medical center, Perryman said. The negative or positive effect (of taking the money versus rejecting the money) on Tyler’s health sector would be about 2.7 times the state average, he said.
Despite the apparent positives to the state, the Texas Association of Business governing board voted Wednesday to not support expansion of Medicaid because there are too many questions regarding the health care act’s cost for businesses.
Anne Dunkelberg, associate director of the left-leaning Center for Public Policy Priorities, said most credible economic data supports expanding coverage.
However, Ms. Dunkelberg said advocacy groups and lobbyists for hospitals and health care providers are trying to shift the conversation toward accepting federal dollars despite GOP insistence that it will lead to poor health care and more national debt.
“There’s not a public health argument against Medicaid expansion and there’s certainly not a fiscal argument against it,” she said. “Really, the folks who aren’t there on it yet are mostly coming from an ideological view.”
Perry’s spokeswoman, Lucy Nashed, said expanding Medicaid is like asking to put another 1,000 passengers on the Titanic and called expansion “reckless and fiscally irresponsible.”
“The cost of Medicaid is consuming a quarter of the state budget, making it harder to pay for other things like public safety and education, and there’s simply no way of knowing how much more expansion would cost in the long run,” she said. “The idea that there’s any real money to expand Medicaid is a joke. The only money Washington is using to bribe states to expand Medicaid is either coming straight from the taxpayer’s pocket or being borrowed from China.”
Other GOP leaders shared the same sentiment that expanding an already ballooning Medicaid program will have a negative long-term effect on states and the nation.
Sen. Bob Deuell, R-Greenville, echoed Ms. Nashed’s conclusion about federal spending amid a debt crisis.
“With $16 trillion in debt and over $100 trillion more in projected unmet obligations for Medicaid, Medicare and Social Security, how can we in good conscience put the federal government more in debt even if those in Washington are willing to do so?”
Deuell, a physician, referenced another economic analysis by Billy Hamilton, which shared similar conclusions with Perryman’s report. He questions Hamilton’s conclusions regarding the positive benefits of expanding Medicaid.
Sen. Kevin Eltife, R-Tyler, said he would reserve comment on Medicaid expansion until the Finance Committee debates it. He said the committee will sort through the facts surrounding the funding.
John Hawkins, senior vice president of government relations for the Texas Hospital Association, said numbers and facts typically trump ideological stances but that the state and nation is facing unprecedented financial situations.
“You can make this work from a policy standpoint and a fiscal standpoint so it is more political at this point,” Hawkins said.
Hawkins said lobby groups are still trying to define how the health care act will affect the businesses they represent but that the numbers appear to show a positive impact on health care providers.
Mary Elizabeth Jackson, a vice president at Trinity Mother Frances, the Tyler Chamber of Commerce chairwoman and a TAB board member, said lobby groups are preparing “strong” arguments for taking the money.
“They are educating legislators and their staff about Medicaid and what the health care reform offers and doesn’t,” she said. “If we’re paying taxes and we have an opportunity to bring those tax dollars back to Texas I know our legislators will want to maximize that opportunity if the value of bringing those dollars back is a good value to all of us in the state.”