“Commissioner Suehs’ estimate is in line with what TPPF projected in our December 2010 report, Final Notice: Medicaid Crisis. Between the growth in caseload, surging medical costs, and the new mandates in ObamaCare, Medicaid will become the largest line item in the next Texas state budget and begin to crowd out priorities such as education.
“Sadly, the Texas Legislature has few good options to deal with this crisis. Texans pay federal taxes toward the Medicaid program, but only get our money back if our state complies with federal benefit and eligibility requirements that provide very little flexibility to the states. The Foundation believes this use of conditional federal funds is a total subversion of state governments and effectively commandeers our state budget and officials into the service of federal policy. We have submitted an amicus brief making this point for the U.S. Supreme Court’s consideration in Florida v. HHS, the lawsuit challenging ObamaCare.
“If the U.S. Supreme Court upholds ObamaCare and the current framework of conditional federal grants, it will put every state on the path to bankruptcy. If states remain in Medicaid, the federal government will co-opt a rapidly growing share of their state budgets for health care, crowding out education, public safety, and other areas in which state government have first responsibility. If states withdraw from Medicaid, they will bear the costs of health care for low-income individuals all by themselves, while their residents continue to pay taxes to subsidize such care in other states. Both paths financially break the states.
“The Foundation hopes that other states will join Texas in resisting federal funds that come with strings attached. This is the best long-term solution to the Medicaid crisis, as it would return both the money and regulatory authority over health care to the participating states.
“One such avenue of reform is the Medicaid Block Grant Waiver passed during the 82nd Texas Legislature. This directs the Health and Human Services Commission to submit a request for a statewide waiver program that allows the state to receive its federal money without all of the strings attached. If Texas can get this waiver approved, it will allow the state to craft a new Medicaid program that would be effective, efficient, and sustainable.”
The Honorable Arlene Wohlgemuth is the Executive Director and Director of the Center for Health Care Policy at the Texas Public Policy Foundation. She served 10 years in the Texas House of Representatives, specializing in health care issues.
The Texas Public Policy Foundation is a non-profit, free-market research institute based in Austin.
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