NCPA - National Center for Policy Analysis

Expanding Medicaid in Texas? Not a Good Idea

January 22, 2015

New Texas Governor Greg Abbott was sworn in this week, and already groups are lobbying for the governor to expand Medicaid with what they call an alternative plan, "The Texas Way," reports Timothy Carney at the Washington Examiner.

Texas is one of the many states that refused to expand its Medicaid program to cover adults up to 138 percent of the federal poverty level. Texas hospital groups are reportedly lobbying the governor to seek a waiver for Medicaid that would expand the program in an atypical way, using tools such as health savings accounts, while other groups have long wanted a classic Medicaid expansion for Texas.

NCPA health care expert Devon Herrick just released a report on Texas Medicaid expansion, explaining that an unqualified Medicaid expansion would be disastrous for the state. What's wrong with Medicaid?

  • One-third of physicians don\'t accept new Medicaid physicians, which means that people enrolled in the program have fewer doctor choices and less access to care than those with private insurance.
  • Doctors are four times more likely to turn away new Medicaid patients than they are to refuse to treat uninsured patients willing to pay out-of-pocket.
  • According to a survey from physician recruiter Merritt Hawkins, the average Medicaid acceptance rate across five specialties was just 23 percent in Dallas and 56 percent in Houston.

Doctors dislike Medicaid because it pays them very little -- just 53 percent of what private insurers pay physicians for the same services. In Texas, the state's Medicaid program pays primary care doctors less than half of what private insurers pay.

Source: Timothy Carney, "Hospital group pushes Texas Gov. Abbott to expand Medicaid," Washington Examiner, January 16, 2015.


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