AUSTIN (December 8, 2012)—Medicaid, the health care program for the disabled, the elderly poor and the impoverished, raises hackles at the state Capitol every two years, mostly because the number in need keeps rising alongside health care costs.

Texas lawmakers also regularly underfund the joint state-federal program to pass a so-called balanced budget, creating a budget deficit when they return to Austin.

In the 2013 legislative session lawmakers must pass a supplemental spending bill to cover the $4.7 billion hole they left in 2011 and the expense is non-negotiable because the federal government requires states to put in $1 to get about $2.

Failure to appropriate the money would shut down Texas Medicaid in March, leaving one in seven Texans without healthcare.