County-Level Projections of Medicaid Expansion’s Impact in Texas, September 2020

More than 950,000 newly-eligible adults would enroll in health insurance under Medicaid expansion in Texas, bringing a projected $5.4 billion in federal dollars to the state. Those are some of the findings of a new study written by Laura Dague and Constance Hughes at the Bush School of Government & Public Service at Texas A&M University. The report was sponsored by Episcopal Health Foundation.

The report summarizes the research on fiscal impacts of Medicaid expansion and provides county-by-county estimates of the number of currently uninsured Texans who would be eligible for Medicaid expansion, as well as how much new federal annual Medicaid spending would be expected if those Texans enrolled in Medicaid.

With a required state matching share of 1 for every 9 federal dollars, and numerous potential offsets for the state portion, the fiscal implications appear to be favorable from the state and local government perspective. In the context of uncertainty around future direct funding for hospitals and the pandemic that continues to damage local economies and health systems, Medicaid expansion may be able to provide some fiscal relief.

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