NYT
A week after newly emboldened Republicans in the Texas Legislature floated a radical cost-saving proposal — opting out of the federal Medicaid program — health care experts, economists and think tanks are trying to determine just how serious they are, and if it would even be possible.
The answer? It is complicated. But that is not stopping some conservative lawmakers in nearly a dozen other states, frantic over budget shortfalls and anticipating new costs from the federal health care overhaul, from exploring it.
“States feel like their backs are against the wall, so this is the nuclear option for them,” said Christie Herrera, director of the health and human services task force for the American Legislative Exchange Council, an association for conservative state lawmakers. “I’m hearing below-the-radar chatter from legislators around the country from states considering this option.”
In Texas, some Republicans — bolstered by their expanded majority in the State House — say the strings attached to Medicaid and the Children’s Health Insurance Program (CHIP) are bankrupting the state, which is staring down a budget hole that some have estimated as high as $25 billion. They argue that states could provide more efficient and cost-effective care for children, the disabled and the impoverished by either giving up federal matching money altogether or getting federal officials to grant states waivers to provide health care as they see fit.
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