A week after a Texas agency reported health care reform legislation would cost the state's Medicaid program an extra $20 billion over the next 10 years, a non-partisan foundation says inaction will exact a greater price.

In a study being issued today, the Robert Wood Johnson Foundation projects that by 2019, Texas' ranks of uninsured, public program spending and individual and employee health care expenses will balloon if reform isn't passed.

“People worry about losing what they have now, but they need to remember that what they have now is likely to change,” said Bowen Garrett, a senior researcher with the Urban Institute's health policy center, which conducted the study for the foundation. “Many who have employee-sponsored insurance will lose it as health care costs go up, and those fortunate enough to keep their plans will pay higher out-of-pocket costs or earn smaller wages as employers decide whether to cut on wages or benefits.”

Looking to 2019

The study, which estimates how coverage and cost trends would change from now to 2019 if health care isn't reformed, found out-of-pocket expenses could increase by more than 35 percent in every state. It found middle-class working families would be hardest hit.

According to the study, the effects in Texas within 10 years include:

• As many as 8.3 million residents would be uninsured, up from 6 million this year.

• The average resident's health care spending would increase as much as 81 percent.

• Employers' premiums would increase as much as 121 percent.

• Medicaid/Children's Health Insurance Program spending would increase as much as 117 percent.

• Uncompensated care would increase by as much as 138 percent.

Health care reform's financial effect on Texas emerged as an issue last week when Republican Sen. John Cornyn told the Senate Finance Committee that Senate legislation expanding Medicaid coverage would cost Texas $20 billion over 10 years, citing a report by the state's Health and Human Services Commission.

‘Unique challenges'

A day later, Texas Gov. Rick Perry upped the figure to $60 billion, citing the commission report's figure if any of the legislation being considered in Congress passes.

A spokeswoman for Perry didn't dispute the Robert Wood Johnson Foundation figures Tuesday but stood by the governor's stated concerns.

“I don't think the governor is against health care reform,” said Katherine Cesinger, Perry's deputy press secretary. “He just believes states have specific, unique challenges and ought to be solved on a state-by-state basis, not a one-size-fits-all basis.”

At the Texas Health and Human Services Commission, spokeswoman Stephanie Goodman also stood by the commission's report. She said the commission agreed with the foundation study that population growth will increase Texas' Medicaid population to 4.5 million by 2019, but noted the Senate bill would add 2.5 million to that amount.