The Brief: May 27, 2010

THE BIG CONVERSATION:

Everything is bigger in Texas, including estimated costs of health care reform.

A new report by the Kaiser Commission on Medicaid and the Uninsured places the cost to the state at $2.6 to $4.5 billion between 2014 and 2019 — well below official state estimates of $25 billion.

The study also says Texas will get more bang for its buck than any other state, because it has had low Medicaid eligibility for so long.

The Tribune’s Emily Ramshaw breaks it down:

Health care reform expands Medicaid access to nearly all individuals with incomes up to 133 percent of the federal poverty line (about $29,000 for a family of four). The Kaiser study estimates that Texas' population of uninsured adults will drop between 49 and 74 percent by 2019, depending on how aggressive the state is with its outreach. That means state Medicaid rolls will grow by between 1.4 million and 2 million people.

The financial burden will largely be borne by the federal government, the Kaiser study reports, covering more than 95 percent of Texas' costs. If Texas sees a 46 percent increase in Medicaid enrollment by 2019, the study notes, it will still only see state Medicaid spending grow by 3 percent. If it sees a more aggressive 64 percent increase in Medicaid enrollment, state spending will rise by 5 percent.

However, Robert Garrett of The Dallas Morning News reports that Stephanie Goodman, a spokeswoman for the Texas Health and Human Services Commission, told that while the Kaiser study and HHSC’s analysis make similar basic assumptions, Kaiser omitted some “very real costs.”

Specifically, Garrett writes, she accuses Kaiser of leaving out “higher state administrative costs and the state's costs of maintaining rate hikes for the primary care docs that are federally paid just for two years, 2013 and 2014.”

Meanwhile, Kaiser Commission executive director Diane Rowland says Texas has made some omissions of its own, specifically the lowered state and local costs of paying for uncompensated care.

CULLED:

• State Rep. Debbie Riddle, R-Houston is working on a sequel to last session’s heated voter ID debate.  She announced yesterday that she will file a new piece of “ballot security legislation that would require Texas voters to show a photo ID or two forms of non-photo ID at a polling place" in 2011. In a statement, Riddle said it was a recent trip to Iraq that inspired her to re-file the legislation, which she has pushed unsuccessfully in the last two sessions. Republicans argue that such legislation is necessary to protect voter integrity, but Democrats say the move I a politically motivated solution in search of a problem. Texas Watchdog recently found evidence of voter fraud in South Texas — but it is generally of the mail-in variety, which voter ID would not prevent.

• A model of a Vietnam War veterans memorial to be installed on the Capitol grounds was unveiled yesterday. Tim Eaton of the Austin American-Statesman reports: “The monument will feature five men on a pedestal. They are positioned in a circle and holding weapons such as a sniper's rifle and an M-16. The figures are meant to represent the racial and ethnic diversity of the people who fought in the war.”

“I think there's a bunch of latent stone-heads out there." — Pollster Daron Shaw on a new University of Texas/Texas Tribune poll showing that 42 percent of Texans are open to the idea of legalizing marijuana.

MUST READ:

• State, federal officials blame one another for air quality impasse — Austin American-Statesman

• White calls for local control of transportation — San Antonio Express-News

• Delicate process to plug Gulf spill continues — Houston Chronicle

• Waiting Their Turn — The Texas Tribune