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View Diary: This Is the GOP's Idea of a "Patient-Centered Health Care System" (78 comments)

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  •  Florida and Texas do not have a state income tax (0+ / 0-)

    If someone gets $1,000 worth of expansion Medicaid care in New York State the federal government would pay $900 and New York State $100.

    The State of New York would then get about $60 of that $1,000 back in personal and corporate income tax, making the net cost to New York of $40.

    In Florida and Texas that Medicaid care might only cost $850 since medical and other costs are cheaper  than in New York. The cost to the federal government would be $765 and the upfront cost to Florida or Texas $85.

    Only about $5 of that $85 would come back via state corporate income taxation, so the net cost of Medicaid expansion care would be $80 per $1,000 of New York State level care.

    The PPACA would have Florida and Texas state governments paying twice the net cost of New York State for expansion Medicaid care items. This is a non-starter in Austin and Tallahassee.

    Also, since providing Medicaid in Florida and Texas is so much cheaper for the federal government (about 15% less), many in Florida and Texas want state Medicaid expansion co-shares waived for lower provider cost states.

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