The United States Supreme Court yesterday upheld the Affordable Care Act. As we stated yesterday, Texas arguably had the most to gain - or most to lose - from however the Court ruled.
Nearly a quarter of the state of Texas is uninsured, giving us the highest rate of uninsured citizens in the country. With the Act in place, that figure could shrink to less than 8 or 9% of all Texans by 2014.
Now that the Act is the law of the land, what does that mean for Texas and Texans? Find out below the jump.
Nearly a quarter of the state of Texas is uninsured, giving Texas the highest rate of uninsured citizens in the country. With the Act in place, that figure could shrink to less than 8 or 9% of all Texans by 2014.
An article last week from Kaiser Health News highlights the problems currently plaguing Texas. According to the piece, in Houston alone, nearly one in three residents doesn't have health insurance. What about federally-backed programs like Medicaid?
Texas has the most stringent requirements for Medicaid in the nation. It's extremely hard to qualify. A single adult has to be exceptionally impoverished to qualify for Medicaid in Texas. Realistically, it almost never happens. Essentially, to qualify for Medicaid in Texas, a person has to be on disability, be pregnant, or be an infant.
The Kaiser article put it thus:
"With its fiscally conservative philosophy and cash-strapped state budget, Texas does not offer Medicaid coverage to childless adults unless they are pregnant, disabled or elderly. Parents of children covered by welfare are eligible for the state-federal health program only if they make no more than $188 a month for a family of three."
The article goes on to cite the fact that many workers in Texas are working full-time or hours exceeding a full-time position; however, they are, in fact, cobbling together multiple positions, and none of those individual jobs offers employer-sponsored health-care; moreover, the percentage of Texans with employer-sponsored insurance is ten percentage points lower than the national average of 61 percent, according to the Kaiser article.
These factors resulted in less care for patients in Texas.
THE ACA IN TEXAS
The Act changes that. It states that every state must allow people to qualify for Medicaid who are at or below 133% of the poverty level according to federal guidelines, and the federal government will increase its role in coverage of those who qualify.
Moreover, even if someone doesn't qualify for Medicaid under the new regime, they would still qualify for federal subsidies on a sliding scale if they are between 133% and 400% of the poverty level according to federal guidelines.
Insurance companies could no longer deny coverage to persons with pre-existing conditions. Annual coverage limits have been eliminated and limits on lifetime coverage are being phased out year-on-year.
Young adults can stay on their parents' plans longer, and preventive care is covered with no out-of-pocket costs.
Further, according to the Center for Public Policy Priorities:
"[C]overage expansions are estimated to bring $119 billion new federal dollars to the state, while Texas must put up about $6 billion from our state budget for its share of the Medicaid expansion."
For a more complete statement of what this means, see the Center's statement.
All of these things mean increased, more accessible coverage.
It also means money coming back to Texas according to Emily Cadik.
Finally, the greatest number of uninsured are the young and healthy. As a result, they are going to widen the number of people across whom the risk is distributed, and so lower costs per capita, while increasing contributions per capita; however, they are not going to be proportionally increasing the burden as they will not be availing themselves of the services at the same rate. In short, the marginal benefit of adding them to the pool greatly outweighs the marginal cost of such.
The court's opinion may be viewed here.