In a large state with more uninsured people than any place in the country, millions will soon get the chance to have good, affordable health coverage. State officials helped, by choosing a path forward that benefits their constituents, improves the health care system and spurs competition among private insurers. Their action helped drive insurance prices down, far below expectations.
Unfortunately, the state where all this is happening is not Texas but California. Here, elected officials put politics ahead of people in an ongoing battle over the president’s health reform law.
The Affordable Care Act still goes into effect here in January — only now we Texans won’t get all the benefits people receive in other states, like California or Arkansas.
First, life will be harder here for roughly a million people because Texas officials rejected a chance to provide a health insurance option to nearly everyone.
The Affordable Care Act was designed so that almost all families could afford health insurance. They wouldn’t have to worry about medical bankruptcies or having to wait to get help for serious diseases like cancer.
Fortunately, in 2014, many low- to middle-income, uninsured Texans will get tax credits to help them gain insurance in a private marketplace. Unfortunately, families who earn incomes below the poverty line will get no break at all because state leaders chose to leave them behind.
Lawmakers decided not to accept available federal money to cover working Texans who earn less than about $23,550 (for a family of four). The Legislature simply refused to bring back home our federal tax dollars to insure these Texans, whether through Medicaid or private markets.
Think about that. The coverage expansion would have been fully paid for for years. It was likely to save about 9,000 Texans’ lives each year, according to the University of Texas Medical Branch at Galveston. Instead, this Legislature chose to create a coverage gap for our citizens.
What’s more, all Texans will feel the consequences of state leaders’ choices. They rejected $6 billion per year in federal funding that would have not only insured more Texans but also benefited our state’s economy. It would have created jobs and reduced unnecessary costs in our health care system.
Twenty-two Chambers of Commerce called on the state to accept this funding. They knew having too many uninsured Texans leads businesses’ costs to rise. For example, tax experts project employers here will wind up paying each year at least $300 million more in penalties for uninsured workers. This is a direct result of Texas rejecting the chance to cover more people.
Communities’ costs will rise, too. The credit rating agency Moody’s warns that rejecting the funding will destabilize bond ratings for local hospitals. That, in turn, means higher interest rates and higher local taxes next year because of the state’s failure to take action.
Finally, health care quality will suffer because of this Legislature. Next year, our hospitals will have to get by with less at a time when hospitals in other states receive new support tied to the coverage expansion.
Every state was supposed to expand coverage, so hospitals would wind up ahead with new paying patients next year, even though some federal funding for hospitals (called Disproportionate Share Hospitals, for those that serve many poor and uninsured patients) will decline.
But when the Supreme Court left the choice about coverage expansion for people in poverty up to each state, Texas decided to leave our hospitals without an option. Now, instead of receiving a big increase in resources with which to provide care, Texas hospitals will experience a straight loss. They’ll have to serve more uninsured people than hospitals in other states with fewer resources than even what they have today.
At some point, Texas will need to get serious about a health care solution for our state and for hardworking, low-income Texas citizens. When that happens, we can save lives and ensure Texas reaps the benefits in our economy and communities. Unless the governor changes course and adds coverage expansion to the Legislature’s call, a solution like that for Texans will have to wait.
Sinatra is communications director for Texans Care for Children.www.covertexasnow.org