A comparative look at the two states' programs can help reveal how the states differ in their goal of providing health care while trying to contain health care costs.
Health care costs are covered through a variety of different sources such as employer provided insurance, Medicare, Medicaid, and individual insurance plans. In Texas, 47 percent of the population is insured through their employer, while the number is 52 percent in New York (Kaiser Family Foundation 1). In addition, New York has 19 percent of its population insured through Medicaid compared to only 12 percent in Texas (Kaiser Family Foundation 1). Medicaid is jointly funded through the states and matching federal funds, which is dependent upon the income level of the state. The matching rate varies between 50 percent and 72.29 percent, with the poorer states getting the larger amount (Flowers 3). While New York receives equal matching funding, Texas gets $1.50 for every $1.00 they contribute (Kaiser Family Foundation 2). Because the eligibility is income dependent and is based on a rate set by the states, the differences in total spending can be significant. Texas's total Medicaid spending for 2006 was $18.1 billion, while New York spent $44.7 billion on the program (Kaiser Family Foundation 2). ...
For example, the annual income eligibility level for working parents is $4824 in Texas, but is $25,755 in New York (Kaiser Family Foundation 2). This results is a significantly higher number of enrollees in New York than in Texas. In addition, Texas, "has forfeited more than $900 million in federal money under the Children's Health Insurance Program (CHIP) during the past six years because it wouldn't put up 28 cents for each 72 cents in federal aid" (Wolf). When these statistics are coupled with the lower rate of employer provided insurance in Texas, the result is that 25 percent of Texans have no health insurance as compared with 14 percent of the citizens of New York (Kaiser Family Foundation 1). This difference is largely the result of the total dollars spent between the two states on Medicaid.
The Medicaid program was initially designed as a means to provide health care for parents and children that had low incomes and few material resources. While Medicare was designed to primarily cover the health care needs of the elderly and disabled, Medicaid is a means tested program where the eligibility is set by number of children and the family income. However, Texas Medicaid has expanded in recent years to include the Children's Health Insurance Program (CHIP), Texas STAR Managed Care, and the Program of All-Inclusive Care for the Elderly (PACE) (Texas Medicaid Program Information). In fact, "Texas is the only state that takes advantage of Medicaid's 1929(b) program, which provides community attendant services that help lower-income elderly clients live at home instead of moving into a nursing facility. Texas has roughly 47,000 Medicaid clients who benefit from this