1. Medicaid Expansion in McLennan County

2. Health spending increases Amount of federal taxes paid by Texas (Greater Waco) citizens and firms is not impacted by whether Texas participates in Medicaid expansion Business Activity Generated Cost of uncompensated care is currently borne by local taxing entities (thus taxpayers) and privately insured persons and employers (through higher premiums) Private funds freed up to be used for other purposes Uncompensated Care Reduced Health insurance reduces morbidity and mortality Improved health outcomes are directly linked to higher productivity Increased Productivity * source: The Perryman Group

3. Net Gain Medicaid funds 2014-2017 $58 million 858 nurses 318 physicians 1,178 new jobs* Direct Annual Payroll $117 million** * source: Center for Public Policy Priorities ** source: Texas Workforce Commission

4. Direct and indirect impact of new jobs created only. Does not include assumptions of reduced local burden of uncompensated care or increased business activity.

7. Primary job Imports new money into the local economy $2 billion payroll Generates new sales in other sectors $475 million taxable sales Attracts new construction and expanded tax base $11 million new residential property