Without Medicaid expansion, Texas hospitals left holding the bag

Austin, Texas.

Should Texas ever decide to expand Medicaid eligibility under the Affordable Care Act, its hospitals would be spared about $358 million a year in costs tied to uncompensated care, a new study has found.

The research was conducted by the Florida-based consulting firm Health Management Associates on behalf of the Texas Health and Human Services Commission, The Dallas Morning News has reported. The report was not immediately available online.

If Medicaid were expanded, about 9 percent of the approximately $4 billion a year Texas' hospitals spend on uncompensated care could be saved, the newspaper reported. Health Management Associates (HMA) predicted about 668,000 Texans out of the 1.1 million eligible for Medicaid coverage would enroll if eligibility were expanded.

But, quoting the report, the newspaper said that Texas lawmakers are not inclined to expand Medicaid anytime soon.

The lack of Medicaid expansion has meant the Lone Star State has enjoyed few benefits from the passage of the ACA into law six years ago. A study issued earlier this year suggested that a physician shortage plus a growing use of narrow networks by insurers operating in the state means many Texans say they have more trouble accessing care than they did in the past. Altogether, it is estimated Texas will forego $100 billion in funding over the next decade by refusing to expand Medicaid eligibility.

The HMA report was apparently commissioned by state lawmakers in order to convince the federal government to keep a five-year-old Medicaid waiver in place, according to The Dallas Morning News. The feds, noting that expansion was available as an option, had declined to continue the waiver on a long-term basis after it was set to expire last spring, but agreed to extend it through the end of the calendar year. The waiver includes about $4 billion in extra money through special property tax levies connected to local hospital districts. Texas' Medicaid program only covers about 70 percent of the cost of hospital care for patients.