Texas must decide whether or not to participate in the Obamacare expansion of Medicaid to the poorest Americans. Here are the facts about what this provision is and how it works after the Supreme Courts’ ruling regard the constitutionality of the reform:

ObamaCare Medicaid Expansion
The ObamaCare Medicaid reforms were meant to expand coverage to up to 21.3 million of our nations poorest. The law had said, prior to the supreme court hearing, that very low-income individuals (those under the 133% FLP line) including adults without dependent children. Even though Medicaid is a federal and state joint program the funding for low income individuals was covered 93% over the next decade by the federal government using tax payer money.

<b>Medicaid Expansion Means, in all States, Individuals with annual incomes up to 133% of the federal poverty line — currently, $14,856 or less — are able to enroll. </b>Right now eligibility differs from State to State.

If a state refused to expand coverage then it would lose all of it’s Medicaid funds, this was meant as a protection to ensure that states supported their poorest equally. However the NFIB repeal ObamaCare effort worked to some extent and now states are no longer required to insure their poorest under ObamaCare, yet they can still receive the full federal funding for their Medicaid program.

So, Texas has a choice to make. It should be a NO Brainer, but this is Rick Perry’s Texas. Now the Legislative Budget Board that makes recommendations on spending has weighted in , in favor of participation.

the LBB is acknowledging just how much cash would be left on the table should the state’s leadership ultimately decide against the expansion. Also, the added coverage is expected to drive down governmental health care costs at the local level as fewer people seek care in hospital emergency rooms. Uncompensated care at hospitals amounted to $3.1 billion in 2011, according to LBB figures.

<b>The federal government would cover 100 percent of the cost of coverage for the 2014-15 state budget cycle. Meanwhile, the cost to the state would be $50.4 million to cover half of the administrative costs of the expansion. In turn, the federal aid over the next two fiscal years for the expansion is expected to be $4 billion, according to the LBB. In other words, the state in its next budget would bear 1.2 percent of the total cost of the expansion.</b>
The state’s share could actually be less than that. The LBB earlier recommended allowing the local taxing authorities that bear the biggest burden of paying for uncompensated care provided by hospitals to cover the match.

But , like the posturing ass he is, has said that he will not let Texas participate in the program. There are reasons to believe that he can’t sustain that asinine position. Paul Burka points out one reason:


Three guesses who is turning backflips at this news. It’s the freshman Republicans, who were facing the prospect of (a) voting for a $7 billion spending bill or (b) telling their hometown doctors, hospitals, nursing homes, and other healthcare providers to go fly a kite.

The other is provided by an analysis on the Kaiser Health News website:

Businesses Will Push Perry to Rethink Medicaid Expansion
But if there’s one thing more powerful than Republican governors’ dislike of the Affordable Care Act, many believe, it may turn out to be the business interests in their own states.

<b>"Once the headlines die down, every hospital in Texas is going to look at Perry and say, ‘Please tell me why we’re not taking money from the federal government to offset my uncompensated care,’"</b> said Thomas Carroll, who follows health insurance stocks for investment firm Stifel Nicolaus. "That is a question that Rick Perry absolutely cannot answer."

A higher portion of Texans lack coverage than residents of any other state. A Texas Medicaid expansion would generate $100 billion in federal money for the state over a decade, according to the state Health and Human Services Commission, and furnish coverage to an estimated 2 million Texans.

At the same time it would generate nearly $1 billion in annual Texas revenue for Amerigroup and WellPoint, calculates Carroll.

Quiet for now, insurers are expected to join hospitals and patient advocates to fight for Medicaid expansion and what are enormous amounts of money, even by Washington standards. Nowhere are the dollars bigger than in Perry’s state, where one in four lacks health coverage.

"Fights seem to follow the money, and there is a lot of money at stake in Texas on this," said Phil King, a Republican state representative from outside Fort Worth who opposes the Medicaid expansion. "Maybe you need to rename this ‘The Full-Employment Act for Lobbyists.’"

For once, maybe greed can serve a larger public good. Texas healthcare for its poor citizens is an abomination before God and man. If the healthcare lobbyist can help change that for their own selfish reasons, so be it.

After Rick finishes pretending he can convince any but the most low tech California companies to relocate here, he will have to deal with this issue. I can’t wait to see what happens.

Rick may well have outstayed his welcome, what with his embarrassing run for the Republican nomination, the ongoing inquiry into his corporate slush fund and all.

Perry looking highly vulnerable 

Texas voters- even Republicans- have had enough of Rick Perry.

PPP’s newest poll finds that only 31% of voters think Perry should seek reelection next year, compared to 62% who think it’s time for him to step aside. He’s among the most unpopular Governors in the country, with only 41% of voters approving of him to 54% who disapprove.

Even though is apparent successor maybe Greg Abbott, at this stage I would gladly accept that outcome if it were the only way to show this arrogant poseur the door.