Texas’ refusal to join the Medicaid expansion, announced by Governor
Rick Perry Monday, will cost hospitals, clinics and taxpayers a lot,
according to local health care officials.  Statesman.com reports that these leaders predict higher costs for taxpayers and patients with insurance to cover the shortage.

sent a letter to the federal government Monday stating that he refuses
to expand Medicaid as the new federal health care law expects because it
would “threaten even Texas with financial ruin.”   He’s also bothered
by what he sees as an intrusion into states’ rights.  The Texas State
legislature, which is controlled by Republicans, is expected to agree
with him.

However, patients without insurance will still have to
get their medical care somewhere, most likely at hospitals and emergency
rooms which have a higher cost for care.  They also will be likely to
utilize clinics that take care of uninsured people and people on
Medicaid, the state-federal program that pays for care for the poor,
disabled and many nursing home residents.  So the bulk of the cost will
fall to local communities.

Central Health officials believe that a
Medicaid expansion would save Travis County’s public clinic system
$7-$8 million a year.  To pay for uninsured people who cannot pay for
their care, hospitals will charge paying patients more and this will
likely result in higher private health insurance premiums.

360,000 people in Travis and other area counties are uninsured, and many
would have gotten on the Medicaid rolls if the expansion had happened.
Statewide 1 in 4 Texans, 6 million total, do not have health insurance. 
Due to this, Texas had been set to get a large share of federal money
to expand Medicaid, about $13 billion a year, starting in 2014.  The
federal government would have been responsible for all of the costs of
the expansion until 2017, when the state would start sharing costs up to
10 percent by 2020.

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