Mar 8, 2013

Medicaid Expansion in Texas -- By the Numbers

Kyle Janek, MD

As the Texas Legislature continues to search for a Texas-style solution to provide health insurance coverage to low-income adults, Texas Health and Human Services Commissioner Kyle Janek, MD, today shared the lay of the land with the House Appropriations Committee.

Based on Census Bureau estimates from March 2012, about 6 million of Texas' 25.5 million population -- or 24 percent -- lack health insurance. Texas continues to lead the nation in the percentage of uninsured. Here's how that 6 million breakdown:

  • 2.4 million (40 percent) would be eligible to buy subsidized health insurance under the Patient Protection and Affordable Care Act (PPACA) insurance exchanges.
  • 1.4 million (23 percent) earn less than 138 percent of the federal poverty level and would be covered by Medicaid if Texas chose to expand the program as described in the PPACA.
  • 851,000 (14 percent) are undocumented immigrants.
  • 790,000 (13 percent) are currently eligible for Medicaid but not enrolled in the program.
  • 608,000 (10 percent) are not eligible for any government health care assistance.

The combination of Medicaid expansion and the PPACA insurance exchanges, Commissioner Janek forecast, would cut the number of uninsured in Texas to 3.1 million, or about 12 percent of the population.

Here are some links to stories that put these numbers in context (political and otherwise);

Finally, we had a report from Gallup today that added some confusion to our numbers. According to the report, Texas' adult uninsurance rate is 28.8 percent, we're still the highest in the country, and the spread between Texas and "second-ranked" Louisiana is growing wider. The discrepancy between Gallup's 28.8 percent and the Janek/Census Bureau's 24 percent comes about because the Census Bureau numbers include children, whose uninsurance rate is lower due to Medicaid coverage that's not available to most adults, due to the Children's Health Insurance Program, and other factors.

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