This creates an odd situation in which the poorest residents, those who would be eligible for Medicaid under the expansion, will receive no assistance, while those with slightly greater incomes will receive subsidies to help purchase insurance.
"Texas leads the country in the number and percentage of uninsured state residents, where more than 25 percent of Texans don't have health insurance, including an embarrassingly high 17 percent of children," Merritt wrote.
Perry's decision not to expand Medicaid will make it impossible for the poorest 1.7 million Texans, whose incomes are less than 138 percent of the "federal poverty level," to qualify for medical assistance, Merritt wrote.
Federal and state governments jointly fund Medicaid programs.
The federal government will cover 100 percent of the funding to expand Medicaid for the first three years. After three years, that number will scale down to no less than 90 percent.
Federal funds are a specified percentage of Medicaid benefits in each state, based on criteria such as per capita income.
The average federal funding rate for Medicaid is currently 57 percent, ranging from 50 percent in wealthier states to 75 percent in states with lower per capita incomes.
During fiscal year 2012, West Virginia received 72.6 percent of its Medicaid expenditures from federal funds, while Texas received 58.2 percent, according to the Department of Health and Human Services.
"Fortunately," Merritt concludes, "we have a governor and state legislature who were able to look beyond the Obama in Obamacare long enough to see that expanding Medicaid was both the right thing to do for our most vulnerable West Virginians and the economically smart thing to do for the state and its labor force."
To read the full Johnson Foundation study go here.
Reach Paul J. Nyden at pjny...@wvgazette.com or 304-348-5164.