Banking on Obamacare for future prisoner hospital costs

At the Austin Statesman, Mike Ward has a story today following up on a subject first raised last month on Grits: The potential to have Texas prisoners' hospital costs covered by the federal Medicaid program beginning in 2014 under "Obamacare." His article opens:

State officials looking for ways to cut the skyrocketing costs of providing health care for Texas convicts are now looking to an unlikely source: the federal health care law signed last year by President Barack Obama.

Under a provision of the law, virtually all state prisoners could be eligible for Medicaid coverage of their hospital stays beginning in 2014 — and the federal government would pick up the tab, officials said Friday. ...

In the past year, hospital costs for the state's prison convicts tallied more than $112.5 million — a 15 percent jump over the previous year. Officials say the state could face a $100 million shortfall for prison health care in the next two years.

Under Medicaid, the feds pay 60% of costs in Texas, though experts estimate that could decline to 50% over the next 6-8 years. With the feds paying 60%, that would reduce the biennial cost of prisoner hospital care in the state budget by $135 million; at 50%, it would still shift $112.5 million to the feds, based on the current budget. That would be more than enough to make up for nine-figure cuts in prisoner healthcare enacted in the latest Texas budget, though the "Obamacare" provisions won't take effect until the next biennium.

I'm no attorney and can't say for sure, but it appears to me these provisions of Obamacare wouldn't be affected by federal litigation aimed at nixing the "individual mandate" for buying health insurance. Instead, it's a function of the portion of the law - almost certainly severable from the individual mandate - that expanded Medicaid coverage for low-income people, including younger men who make up most of the prison population and are almost by definition indigent while they're locked up. The 11th Circuit Court of Appeals that most prominently ruled against the individual mandate earlier this year did not claim that striking that provision would shut down the rest of the law. So barring something completely unforeseen - like an actual, Congressional repeal of the relevant provision in 2013 - Texas will soon have the option to sign up prisoners for Medicaid to pay for their hospital coverage. Given how much money they'd leave on the table if they chose not to do so, Grits doesn't see eschewing federal money for prisoner healthcare in 2014 as a realistic option.

RELATED: Obamacare provision a boon to budget writers on state prison health costs but complicates UTMB negotiation