Texas continued to have the highest rate of people without health insurance in 2012 at 24.6 percent, or more than 6 million residents, according to the Current Population Survey estimates released by the U.S. Census Bureau this week.
Texas also has the largest number of children without health insurance and the highest rate of poor adults without health insurance, according to 2012 American Community Survey estimates.
More than 852,000 Texas children lacked health insurance in 2012, according to the ACS estimates, which are taken from a random sampling of households throughout the year. California, which has 2.2 million more children than Texas, had the second-highest number of uninsured children at 717,000.
Texas also had the highest rate of adults making below 138 percent of the federal poverty threshold — lower than $15,415 for an individual or $26,344 for a family of three — who lack insurance, at 55 percent. Those people would have qualified for Medicaid coverage if the state had chosen to expand eligibility under the federal Affordable Care Act.
“There is just an awful lot of people priced out of the [health insurance] market in Texas because of our Wild West regulatory approach on the rate side,” said Anne Dunkelberg, associate director of the left-leaning Center for Public Policy Priorities.
She attributed the high rate of uninsured to the lack of regulations governing Texas’ individual and large employer health insurance markets, the exclusion of most poor parents and all other adults from the state’s Medicaid program, and the lack of employer-sponsored coverage in many of Texas’ predominant industries, such as agriculture, food service and construction, among other factors.“I think that we have an unhealthy obsession with the uninsured rate in Texas,” said John Davidson, health policy analyst at the conservative Texas Public Policy Foundation. “It distracts us from the much more important question of health care for the indigent population. Insurance and care are not the same things.”
Alternative health care models, such as programs that offer sliding-scale payment rates for low-income people, can contain costs without reducing access to care, he said. For example, he cited the CareLink program run by the University Health System in Bexar County, which provides payment plans and sliding-scale rates for families who make less than 300 percent of the federal poverty level.
“Being on an insurance plan doesn’t mean you have good health care or you have access to health care,” Davidson said. “I think this is most obvious when you look at our Medicaid program,” which he said has “terrible problems with access to care.”
The ACS estimates that 1.6 million adults with incomes below 138 percent of the federal poverty threshold had insurance in 2012, while 2 million were uninsured.