Health Insurance 4 Everyone Blog

Nearly a quarter of the Texas population lacked health insurance in 2010, according to the most recent data released by the American Community Survey, which the U.S. Census Bureau conducted. That’s more than 5.7 million Texans.  More than half of the uninsured are employed. More than a third have an annual household income above $50,000. And more than 1 million have college experience or post-secondary degrees.

The lack of health insurance coverage is a well-known problem in Texas.  Govenor  Rick Perry is opposed to a mandatory health insurance policy, and the debate over how to expand insurance coverage is complicated. 

But while Perry condemns both efforts to make carrying health insurance mandatory, his home state of Texas faces a staggering crisis in health coverage: Texas leads the nation in the size of its uninsured population, has the third-lowest percentage of people covered by their employers, and spends less per capita on Medicaid, the joint state-federal insurance program for the disabled and poor children, than all but one other state.

Texas comes into the health insurance game at a disadvantage.  Texas is responsible for more than 40 percent of new jobs created in America since June of 2009. But many of those jobs are in the service industry, in agriculture, construction and the small business sector, which either don’t provide insurance, or don’t pay their workers enough to purchase it. Texas Medicaid is austere — many low-income Texans who might qualify for public insurance in other states don’t qualify in Texas.

Just 50 percent of Texans get insurance through their employers, 10 percentage points below the national average. And though health insurance premiums in Texas are slightly below the national average, they have nearly doubled in the last decade. Despite suggestions that Texas’ illegal immigrants are to blame for the sky-high rate of the uninsured, they make up just one-sixth of the total, according to an analysis by the left-leaning Center for Public Policy Priorities.

Perry’s office says the governor has gone to great lengths to help Texans get insured through the free market, without the misguided approach of forcing them to purchase coverage. His aides did not offer a number for how many Texans have obtained health insurance due to his efforts, saying many of the initiatives were relatively new.

His aides tout legislation he signed to let insurers offer lower-cost, smaller-scale health plans to consumers, to let single-employee businesses join health care cooperatives, and to help employers pay for their workers’ health care without negative tax consequences.

During his tenure, Texas created a health insurance pool to sell policies to people with uninsurable medical conditions, and received a multimillion-dollar federal grant to develop tools to increase private insurance coverage.

Perry and Republican leaders have fought efforts to implement federal health reform in Texas.  Meanwhile, the growing ranks of the uninsured have placed extraordinary burdens on Texas’ health care providers, including cash-strapped public hospitals and clinics.

Following a 2007 “State of the State” address where Perry proposed a plan to provide affordable insurance to two million working-poor Texans largely at the federal government’s expense, he sought a waiver that would’ve redirected hundreds of millions of dollars slated for uncompensated care to a low-income insurance pool. That pool would’ve provided monthly premium assistance to help people buy their own insurance.

That waiver wasn’t approved by the Bush administrations, which had concerns that it would curb Medicaid eligibility and enrollment.  Another Medicaid waiver proposal sent to the Obama administration this year, one that has received initial approval, wouldn’t increase health insurance coverage, but is aimed at helping safety net providers care for the uninsured.

Arguably the most successful private health insurance initiative of the last decade is the 2009 Healthy Texas program, aimed at helping small businesses provide insurance to their employees. The program was appropriated $35 million over the 2010-11 bienniums with the goal of covering at least 20,000 people once it was fully implemented. To date, just 5,000 people are covered, but Perry’s office says enrollment has grown every month since last September.

Texas is in a state of crisis when it comes to health care coverage and has yet to come up with a program that makes a significant change.  Whomever is in office after the next election-one fact remains-someone has to come up with a better plan for the state of Texas and this country.