To get a better handle on the extent of this problem, I reviewed the Texas State Health website.
Unlike other States like California, Florida, Tennessee and Indiana, Texas has decided to not be totally transparent with its citizens and show them how much profit or loss each of its hospitals are making.
But Texas did reveal 2011 Bad Debt Charges, Charity Care Charges and Net Patient Revenues for each of 539 of its Acute Care Hospitals that returned hospital surveys.
These Bad Debt Charges and Charity Care Charges are particularly relevant in assessing the financial impact if Texas were to Expand Medicaid fully.
The amounts of these Texas Hospital Bad Debt Charges and Charity Care Charges are just mind-boggling.
These 539 Texas Acute Care Hospitals had Total Bad Debt Charges of $7.785 bil in 2011, which was a huge 13.7% of their Total Net Patient Revenues of $56.648 bil in 2011.
And these 539 Texas Acute Care Hospitals had Total Charity Care Charges of $10.297 bil in 2011.
If Texas were to Expand Medicaid fully, a substantial portion of these two massive amounts would be reduced, resulting in a huge increase in Hospital Patient Revenues.
Since Texas Hospitals would get substantially enhanced financially from Medicaid Expansion in Texas, it only makes sense that hospital patient prices would decline, health insurance premiums would decline, the State of Texas financial coffers would be substantially enhanced, and Texas taxes assessed on individuals and businesses would also decline, especially Property Taxes which are now financing the massive Operating Losses of the Texas County District Hospitals.
First, below here are the 41 individual Texas Hospitals with Combined Bad Debt Charges and Charity Care Charges of at least $100 mil each in 2011. The Totals for these 41 Hospitals comprise 51% of Total Bad Debt Charges and 72% of Total Charity Care Charges of all 539 Texas Acute Hospitals combined:
| 2011 | |||||
| 2011 | 2011 | Net | |||
| Bad | Charity | Patient | |||
| Texas | Texas | Debt | Care | Service | |
| County | City | Texas Hospital Name | Charges | Charges | Revenues |
| $ mils | $ mils | $ mils | |||
| Dallas | Dallas | Parkland Memorial Hospital | 337 | 1,195 | 657 |
| Harris | Houston | Harris County Hospital | 327 | 1,101 | 475 |
| Bexar | San Antonio | Baptist Medical Center | 894 | 51 | 932 |
| Tarrant | Fort Worth | John Peter Smith Hospital | 282 | 649 | 612 |
| Travis | Austin | University Med Ctr Brackenridge | 71 | 360 | 346 |
| Bexar | San Antonio | University Hospital | 64 | 293 | 386 |
| El Paso | El Paso | University Medical Center El Paso | 116 | 190 | 205 |
| Bell | Temple | Scott and White Memorial Hospital | 66 | 221 | 775 |
| Smith | Tyler | Mother Frances Hospital | 30 | 249 | 488 |
| Lubbock | Lubbock | University Medical Center | 208 | 34 | 374 |
| Harris | Houston | The Methodist Hospital | 28 | 210 | 1,167 |
| Hidalgo | Edinburg | Edinburg Regional Medical Center | 31 | 195 | 376 |
| Harris | Houston | University of Texas Anderson Cancer Ctr | 47 | 178 | 2,777 |
| Bexar | San Antonio | Methodist Hospital | 90 | 123 | 1,306 |
| Harris | Houston | Memorial Hermann Hospital | 28 | 179 | 954 |
| Dallas | Dallas | Baylor Medical Center | 73 | 128 | 1,021 |
| Smith | Tyler | East Texas Medical Center | 64 | 137 | 410 |
| Nueces | Corpus Christus | CHRISTUS Spohn Hospital Hospital Corpus Christi | 42 | 156 | 542 |
| Lubbock | Lubbock | Covenant Medical Center | 63 | 128 | 602 |
| Gregg | Longview | Good Shepherd Medical Center | 96 | 81 | 352 |
| Tarrant | Fort Worth | Texas Health Harris Methodist Ft Worth | 52 | 121 | 691 |
| Potter | Amarillo | Northwest Texas Hospital | 29 | 140 | 287 |
| Dallas | Dallas | Methodist Dallas Medical Center | 24 | 144 | 388 |
| Bexar | San Antonio | CHRISTUS Santa Rosa Hospital | 36 | 130 | 582 |
| Galveston | Galveston | University of Texas Medical Branch Hosp | 113 | 44 | 473 |
| Jefferson | Beaumont | CHRISTUS St Elizabeth Hospital | 37 | 114 | 387 |
| Wichita | Wichita Falls | United Regional Health Care System | 31 | 120 | 307 |
| Webb | Laredo | Laredo Medical Center | 87 | 36 | 287 |
| Dallas | Dallas | Children's Medical Center at Dallas | 52 | 67 | 934 |
| Harris | Houston | St Luke's Episcopal Hospital | 35 | 81 | 882 |
| McLennan | Waco | Hillcrest Baptist Medical Center | 50 | 61 | 229 |
| Harris | Cypress | North Cypress Medical Center | 54 | 53 | 401 |
| Ector | Odessa | Medical Center Health System | 88 | 19 | 186 |
| Dallas | Dallas | Methodist Charlton Medical Center | 22 | 81 | 212 |
| Harris | Houston | Memorial Hermann Southwest Hospital | 69 | 33 | 331 |
| Cameron | Harlingen | Valley Baptist Medical Center | 57 | 45 | 285 |
| Brazos | Bryan | St Joseph Regional Health Center | 30 | 71 | 289 |
| Harris | Baytown | San Jacinto Methodist Hospital | 24 | 77 | 213 |
| Travis | Austin | Seton Medical Austin | 23 | 77 | 432 |
| Harris | Pasadena | Bayshore Medical Center | 61 | 39 | 327 |
| Angelina | Lufkin | Memorial Medical Center of East Texas | 61 | 39 | 174 |
| Total all 41 Texas Hospitals | 3,992 | 7,450 | 23,054 |
And second, below here are the 31 individual Texas Governmental Hospitals with Combined Bad Debt Charges and Charity Care Charges of at least $10 mil each in 2011. The Total Bad Debt Charges of $1.944 bil were an incredibly huge 23.7% of the Total Net Patient Revenues of these 31 Texas Governmental Hospitals. And Total Charity Care Charges were an even much higher $3.933 bil. If Texas were to Expand Medicaid fully, this is where the substantial Property Tax reductions should eventually occur:
| 2011 | |||||
| 2011 | 2011 | Net | |||
| Bad | Charity | Patient | |||
| Texas | Texas | Debt | Care | Service | |
| County | City | Texas Hospital Name | Charges | Charges | Revenues |
| $ mils | $ mils | $ mils | |||
| Dallas | Dallas | Parkland Memorial Hospital | 337 | 1,195 | 657 |
| Harris | Houston | Harris County Hospital | 327 | 1,101 | 475 |
| Tarrant | Fort Worth | John Peter Smith Hospital | 282 | 649 | 612 |
| Bexar | San Antonio | University Hospital | 64 | 293 | 386 |
| El Paso | El Paso | University Medical Ctr El Paso | 116 | 190 | 205 |
| Lubbock | Lubbock | University Medical Center | 208 | 34 | 374 |
| Harris | Houston | University Texas Anderson Cancer Ctr | 47 | 178 | 2,777 |
| Galveston | Galveston | University Texas Medical Branch Hosp | 113 | 44 | 473 |
| Ector | Odessa | Medical Center Health System | 88 | 19 | 186 |
| Midland | Midland | Midland Memorial Hospital | 56 | 15 | 235 |
| Dallas | Dallas | Univ Texas Southwestern Med Ctr | 37 | 31 | 568 |
| Victoria | Victoria | Citizens Medical Center | 40 | 17 | 168 |
| Harris | Tomball | Tomball Regional Hospital | 34 | 15 | 181 |
| Nacogdoches | Nacogdoches | Nacogdoches Memorial Hospital | 13 | 27 | 78 |
| Fort Bend | Richmond | OakBend Medical Center | 23 | 16 | 69 |
| Hunt | Greenville | Hunt Regional Medical Ctr Greenville | 27 | 8 | 114 |
| Wise | Decatur | Wise Regional Health System | 25 | 9 | 121 |
| Guadalupe | Sequin | Guadalupe Regional Medical Center | 10 | 17 | 86 |
| Bee | Beeville | CHRISTUS Spohn Hospital Beeville | 4 | 14 | 33 |
| Titus | Mount Pleasant | Titus Regional Medical Center | 13 | 4 | 64 |
| Cooke | Gainesville | North Texas Medical Center | 10 | 7 | 30 |
| Uvalde | Uvalde | Uvalde Memorial Hospital | 9 | 7 | 48 |
| Matagorda | Bay City | Matagorda Regional Medical Ctr | 12 | 3 | 47 |
| Smith | Tyler | University Texas Health Center-Tyler | 13 | 1 | 43 |
| Hopkins | Sulphur Springs | Hopkins County Memorial Hospital | 8 | 5 | 52 |
| Val Verde | Del Rio | Val Verde Regional Medical Center | 10 | 3 | 46 |
| Brazoria | Angleton | Angleton-Danbury Medical Center | 12 | 1 | 25 |
| Bexar | San Antonio | Texas Center for Infectious Disease | - | 13 | - |
| Jasper | Jasper | CHRISTUS Jasper Memorial Hospital | 3 | 9 | 27 |
| Palo Pinto | Mineral Wells | Palo Pinto General Hospital | 3 | 8 | 31 |
| Total all 31 Government Hospitals | 1,944 | 3,933 | 8,211 |
Look how incredibly high both the Bad Debt Charges and Charity Care Charges of the Top 5 above are relative to their related Revenues. These will be the Hospitals with just massive Operating Income Improvement if Medicaid were fully Expanded in Texas.
