The Facts
* According to the Congressional Budget Office (CBO), federal spending on Medicaid will more than double over the next decade, increasing from $265 billion to $572 billion. The CBO estimate confirms TPPF projections from 2010 that show Medicaid spending will double every decade on the state and federal level.
* Medicaid spending as a share of state budget has steadily increased, from about 20% in 2000 to nearly 30% in the 2014-15 All Funds budget ($58.5 billion).
* In General Revenue (GR) spending, the 2014-15 budget is $95.6 billion. Of this, about $28.6 billion is for Medicaid (excluding an estimated $1.5 billion shortfall in Medicaid funding). This represents 30% of the GR budget, up from 14% in 2001.
* Medicaid expansion is estimated to cost the state $8.8 billion over 10 years. According to projections from expansion proponents, expansion would cost $3.74 billion in state matching funds for the years 2014-17.
* According to a Texas Medical Association poll, only 31% of Texas physicians would accept all new Medicaid patients in 2012, down from 67% in 2000.
* Total Medicaid enrollment in Texas is rising because of other provisions in the ACA. Enrollment is currently about 3.7 million and is expected to continue to rise in 2015.
Recommendations
* Lawmakers should resist calls to expand Medicaid under the ACA and instead focus on improving the existing program.
* Any consideration of a “private option” or a “Texas Solution” for Medicaid expansion should be evaluated in light of waiver programs for expansion in other states, especially Arkansas, Indiana, and Michigan.