Lone Star Debacle - The High Price of Obstructing Health Reform

Samuel L. Dickman, University of California, San Francisco, Colleen M. Grogan, University of Chicago, Lawrence R. Jacobs, University of Minnesota, Markie McBrayer, University of Houston, Sara Rosenbaum, Milken Institute School of Public Health, George Washington University, Jessica Sharac, George Washington University, Peter Shin, Milken Institute School of Public Health, George Washington University, Ling Zhu, University of Houston

Almost a quarter of Texans do not have health insurance – and 13% of all uninsured Americans live in the state. Millions could gain coverage through the Affordable Care Act. But ultra-conservative Texas authorities are doing all they can to block and sabotage reform – hurting health and wellbeing and imposing unnecessary costs on hospitals, community clinics, and state finances.

SSN scholars have looked closely at the extra and unnecessary costs Texas people and health care institutions are paying because of the state's decisions to obstruct exchange enrollments and refuse new federal funds to expand Medicaid. The picture is not pretty – and the juxtaposition of America's two largest states, California and Texas, dramatizes the impact of state-level cooperation versus obstruction on the progress of health reform.

> While California Expands Insurance Coverage, Texas Blocks Health Reform - Despite Greater Needs
Ling Zhu and Markie McBrayer, University of Houston

> How Community Health Clinics and Uninsured Millions are Hurt by the Refusal to Expand Medicaid in Texas
Jessica Sharac, Peter Shin, and Sara Rosenbaum, George Washington University


Related SSN briefs on Medicaid expansion, community health clinics, and the health costs of failure to expand Medicaid:

> Expanding Medicaid is Cost-Effective and Popular, So Why are So Many States Resisting?
Colleen M. Grogan, University of Chicago

> Community Clinics - The Hidden Health Revolution
Lawrence R. Jacobs, University of Minnesota

> Life and Health Will Suffer in States Opting Out of the Medicaid Expansion
Samuel L. Dickman, Harvard Medical School

February 2014