Texas' Republican leadership has fought tooth and nail against federal health care reform, adamantly opposed to taking either money or direction from the Obama administration when it comes to providinghealth care for the poor.

But putting politics aside,public health care costs in Texas are rising about $1.3 billion over the next two years, according to one legislative budget estimate. Medicaid enrollment is growing, whether or not the state decides to accept more federal funds toexpand the program's coverage to poor adults.And fiscal conservatives are raising the possibility,for first time in recent memory, that state appropriators will this year allocate more money for health care than education.

With the Senatesbudget estimate expected to be released Tuesday morning, we take a look at the health care numbers lawmakers will be grappling with for the next four months.

1. Expect less help from the feds.

The silver lining here is that the average Texan is on the upswing,with average incomes risingin recent years. But because of that, the feds are asking the state to shoulder more of its own health care costs.

The share of Medicaid paid by the federal government is going down, slightly, from 58.05 percent in 2015 to 57.13 percent in 2016. That drop may seem small, but even a slight change to a budget behemoth like Medicaid, which insures about 4.1 million Texans,comes with big fiscal consequences for state lawmakers.

The less favorable federal match means Texas will have to pull nearly $750 million moreout of state coffers over the next two years just to continue providing the level of care it does now, according to the House budget estimate. That cost, however, will be partlyoffset by about $300 million in newfederal money for certain children in the Medicaid program, made available under the federal health law.

2. Medicaid keeps growing.

Public spending on health care is on the rise in Texas, to the tune of about $1.3 billion over the next two years and thats based on an estimate that does not include inflation of health care costs. The main culprit? More Medicaid enrollees.

Federal health reform, which mandates that most Americans have health insurance or pay a fine, continues to be a big driver of Medicaid growthbecause more people are enrolling now who were previously eligible but nonetheless uninsured.State health officials predict the Affordable Care Act will swell Texas Medicaid participation by more than 560,000 people in 2015, including nearly 140,000 adults who were previously eligible.

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