A Georgetown University Center for Children and Families report released today found some surprising news for Texas children. Even though the state continues to have the most uninsured children in the nation, the Lonestar State has made real progress in covering kids, with about a quarter of a million fewer uninsured children than it had four years ago. In fact, no state has seen as large of a positive swing in the number of children with health insurance.
“This is good news for children and the state of Texas since health insurance coverage greatly improves the economic security of families who are faced with tough budget decisions on a daily basis,” said Laura Guerra-Cardus with the Children’s Defense Fund – Texas. “Investing in our children’s health today helps create a strong workforce tomorrow since kids with coverage show up to school ready to learn and stay in school longer.”
Between 2009 and 2012, the number of uninsured children in Texas dropped by about 4 percentage points, with an estimated 256,000 children gaining coverage, according to data from the Georgetown University research center. A new report on improvements between 2010 and 2012 attributes the gains to the success of Medicaid and the Children’s Health Insurance Program (CHIP) in reaching uninsured children.
“Medicaid and CHIP are examples of federal-state partnership programs that work,” said Joan Alker, author of the Georgetown University CCF report. “Together they are improving health insurance coverage for children and are a testament to what states can accomplish when they lean in and work with the federal government to meet the needs of their residents.”
The Georgetown University CCF report found that in the state of Texas, about 84 percent of children had coverage, which is not as high as the 98 percent coverage rate for seniors, but better than the coverage rate for adults ages 18-64 in 2012. About two-thirds of working-aged adults have health insurance. Many of these adults fall into the so-called coverage gap, which means they would be eligible for Medicaid coverage if and when Texas accepts federal funds to improve that vital federal-state partnership.
A national survey released along with the Georgetown University CCF report found that getting all children covered is important to Americans. Almost nine out of ten (88%) surveyed said they wanted all children in their state to get covered.
“The truth is, as of this fall, nearly every Texas family can find health coverage for their children that fits with the family budget, now that new options are opening up in the Health Insurance Marketplace,” said Clayton Travis with Texans Care for Children. “That’s good news for everyone, as more kids will be able to stay healthy, show up for school and get ahead in life when they have the coverage they need.”
Families interested in finding out if their children qualify for Medicaid, CHIP or financial support with a new health plan in the marketplace should visit HealthCare.gov or call (800) 318-2596.
For earlier data from 2009 and 2011, read the Georgetown University Center for Children and Families prior report here.
Written by: Christine Sinatra, Texans Care for Children. Cross-posted at State of the Children blog.
Having completed my online and in-person training, I was able to sign up for a 4-hour shift on the first day of open enrollment. It’s no longer news that the www.healthcare.gov web site was not functional on day one, and as I write this HHS and their contractors are still struggling with it.
On October 1, though, people were hungry for basic information, so there was plenty to talk about. With the options to consider, it seemed unlikely many folks could have been ready to complete the whole process at one sitting. In four hours, I worked with seven families. Diverse as they could be, all wanted affordable health care for their families and children.
I was happy to be able to tell two different couples (in their 50s and early 60s) with grown kids that they would qualify for discounts on their premiums. Two other families each had so much uncertainty about their 2014 income that we couldn’t be sure yet whether they would qualify for Marketplace premium help—or if the parents would fall into the Texas Medicaid Coverage Gap and stay uninsured. One mother with two children in Medicaid today learned that she was, in fact, left out in Texas due to our failure to expand Medicaid for adults. And I was able to assure an applicant that no premium discrimination would be allowed based on sexual orientation.
Each one of these families was headed by one or more workers. The highest income of the seven families I worked with that day was about $48,000, right around the median household income for Texas—half of Texan households earn less than that. All of them were courteous, appreciative, and trying hard to master their options despite the technology shortcomings. Insure Central Texas is doing a great job educating as many people as possible and trying to overcome the computer obstacles, and this work is going on in community organizations all across the country.
Uncooperative computer systems aside, it is still satisfying to see families get excited at the prospect of greater financial security and access to good care. Fingers crossed, I hope to be able to report soon on getting a family all the way to selecting a health plan and paying their first premium!
Written by: Anne Dunkelberg, Center for Public Policy Priorities. Cross-posted from Better Texas Blog.
On Tuesday, something important becomes possible for the first time for millions of Americans. That something is finding health insurance that meets their needs and also fits their budget.
At the nonprofit organizations where we work, we hear from uninsured Texans desperate for better health care options. Some are young and in good health, but they worry about what happens if a sickness or accident comes their way.
This commentary appeared in the Austin American-Statesman. It was co-written by former Texas Well and Healthy organizing director Mimi Garcia, now Texas state director of Enroll America, and by Christine Sinatra, communications director for Texans Care for Children. Cross-posted at the Texans Care for Children Newsroom.
Important news came out this week about Texas and its uninsured children. The Census Bureau released data on how many people have health insurance, as well as data on poverty and income levels. If we look at how our children’s health coverage fared there are two stories to tell. One is: Texas is doing better at enrolling our children in health insurance programs. The other is: We still need to do more, as evidenced by the fact that we have more uninsured kids than any state.
First, for the good news. According to an analysis of past Census data from The Urban Institute and funded by the Robert Wood Johnson Foundation, the rate of Texas children who are eligible for and enrolled in Children’s Medicaid or the Children’s Health Insurance Program (CHIP) has been steadily increasing. Texas had a participation rate in public insurance for children of just 75% back in 2008, but it climbed to 76% in 2009, and 80% in 2010, an earlier report showed; it was up to 82% in 2011, according to the latest report. The availability of these critical, affordable health insurance options cuts the number of uninsured children by hundreds of thousands in just a few years.
This is great progress that Texas can be proud of. Hard work within state agencies to make improvements to our CHIP and Medicaid system over the years, community partners working across Texas to enroll children and the efforts of people involved with the Connecting Kids to Coverage Challenge have all helped make this possible. Participation rates in the state are expected to continue to grow with implementation of the Affordable Care Act in 2014.
However, it isn’t all good news on the children’s coverage front. Texas has the highest overall number of uninsured children and of Medicaid- or CHIP-eligible kids not enrolled. In 2011, the Urban Institute report says, Texas children made up 15% of the nation’s total eligible but uninsured kid population. In fact, although our Medicaid and CHIP participation rate increased, it was still the eighth-worst among states.
Children not being able to get enrolled in the public health insurance options designed for them is an underlying cause for Texas’ high children’s uninsured rate overall. This translates to over 1 million Texas children without insurance of any kind, according to the Census’ Current Population Survey. This is a missed opportunity for all Texans. When children have healthcare coverage they are more likely to:
- stay healthier with regular checkups,
- get needed immunizations,
- be in school learning instead of home with a sickness and
- get medical care before a small illness can turn into a big one.
Opportunities through federal health reform will ensure that nearly every child has access to affordable coverage. Starting Oct 1, Texas families can enroll in coverage through the federally facilitated Health Insurance Marketplace. Financial assistance will be available to make coverage fit with families’ budgets, even for the families who have traditionally been priced out of the market.
There are also a number of changes coming for families enrolling their children (or expectant moms) in Medicaid and CHIP. The Affordable Care Act is cutting some of the red tape that stood between families and the coverage they need for their children—meaning kids who were once denied services might be able to get help now, and stay covered, too.
Finally, if Texas gets smart and decides to allow low-income hard working parents to enroll in Medicaid, studies show that their children are more likely to be enrolled and stay enrolled. The pieces are there to give all children the healthcare coverage they need. It’s up to state leadership to put them together.
Written by: Clayton Travis, Texans Care for Children. Cross-posted from State of the Children blog.
This week’s Census release shows that Texas still has the highest rate of uninsured in the United States, at 24.6 percent, or 6.4 million, reaffirming the need for affordable health coverage for all Texans. Thanks to the Affordable Care Act, in 2014, uninsured Texans above the poverty line (e.g. $23,550 for a family of four) will finally have options for new, affordable health coverage.
We know what works to reduce uninsured rates. Fifteen years ago, 1 in 4 Texas kids was uninsured, but today, thanks to Medicaid and the Children’s Health Insurance Program, the overall uninsured rate for Texas kids is down to 1 in 6 (16.4 percent). Clearly, making affordable health coverage available for low-income and poverty-level Texans makes a real difference.
The latest data show nearly 1 in 3 working-age adults in Texas ages 19-64 (32.1 percent) is uninsured and are nearly twice as likely to be uninsured as Texas children. Texans are much less likely to get health coverage through their jobs, or their spouse’s or parent’s job, than the average American, with 51.6 percent of Texans under 65 receiving employer-based health insurance compared to 58.4 percent of Americans.
These facts show us why the new health insurance marketplace created by the Affordable Care Act is so important. It will give uninsured Texans above the poverty line who don’t have a quality affordable employer-based health plan a new way to get good coverage at prices that fit their budgets.
However, because our state leaders have refused to accept federal funds from the Affordable Care Act to expand Medicaid, Texas’ uninsured adults ages 19-64 below the poverty line are left with no help. In other words, the parents in a family of four making $25,000 can apply for a generous subsidy through the health insurance marketplace, but the parents in a family of four making $22,000 won’t be eligible for help. Today’s data show about 1 million US citizen Texas adults below the poverty line were uninsured in 2012, making up 1 in 6 of all uninsured Texans.
Our state leaders must act to provide more options for our poorest Texans so they can have the opportunity for quality, affordable health coverage like those above the poverty line.
For more details from the U.S. Census Bureau, click here.
Written by: Anne Dunkelberg, Center for Public Policy Priorities. Cross-posted from Better Texas Blog.
During the legislative session, Texas had an opportunity to accept a path to coverage for hundreds of thousands of working poor Texans, who otherwise will remain uninsured. Some of the strongest voices calling for Texas to accept this coverage expansion came from the private sector. That support has remained strong in the months since the session ended without elected officials taking action on this important matter.
First, some background: The Affordable Care Act allows Texas and other states to draw down federal funding that would fully pay for coverage for its poorest citizens. Sometimes called “Medicaid expansion” and other times, given the various approaches states are taking to expanding coverage, simply a “health care solution,” this initially was written into the law in a way that would make it automatic for every citizen below the poverty line (and some slightly above it, too). When the Supreme Court ruled on the constitutionality of the nation’s health law, however, they made this coverage optional for states. Texas is among the hold-outs, refusing to accept the funding and the path to coverage, even though it would create jobs, help local economies and give Texans financial security and peace of mind.
In the spring, our Texas Well and Healthy campaign, in partnership with other health care advocacy groups, mapped out support for a health care solution. As you can see, the support was widespread and included more than 20 business groups and chambers of commerce around the state.
Since then, even more chambers of commerce have chimed in in support of drawing down federal funds to cover more Texans. In emails to our friends at Consumers Union, representatives of the Greater Beaumont Chamber of Commerce, the Huntsville-Walker County Chamber of Commerce, and the Texas Association of African American Chambers of Commerce all confirmed support for a health care solution to get the nearly 1 million Texans covered who otherwise are likely to remain uninsured.
This week, the board president at my organization, Texans Care for Children, Chris Taylor again made the private sector case for our state leaders to reconsider. In an op-ed for the Austin American Statesman, Taylor discussed why “Good Health is Good Business”:
In the future, the governor and lawmakers can choose differently. What has been called “Medicaid expansion” for states actually offers a lot of flexibility. For example, it may mean covering those eligible for Medicaid under this part of the Affordable Care Act using private insurance in the health insurance marketplace.
In a recent visit to Texas, Health and Human Services Secretary Kathleen Sebelius indicated the administration is open to a “uniquely Texan” approach like that, so people here, regardless of income, can get the health coverage they need.
If they don’t, then even with the other improvements in coverage we’ll see next year, there will continue to be far too many uninsured Texans. The uninsured will still be forced to seek care in the costliest possible places, which are our hospital emergency rooms.
When those patients can’t pay for that care, as so often happens, the cost will keep getting passed along. That means higher local taxes and higher insurance premiums for businesses and individuals.
It’s simply not financially prudent to keep asking local communities to foot the bill for our uninsured when better options exist. Texas economists have said extending coverage just to the 1 million people who would qualify for Medicaid expansion would generate an extra $300 billion in economic activity over a decade for our state.
Texas can and must embrace solutions that get more people in our state covered. Many businesses will tell you: the sooner the better.
Written by: Christine Sinatra, Texans Care for Children
A new report from the Center for American Progress Action Fund shows just how much Texans stand to benefit from Obamacare. Though some members of Congress are yet again pushing to repeal the nation’s health law, the law will help reduce the number of uninsured people and prevent insurance companies from denying care to people with pre-existing conditions, along with lots of other benefits.
Among the report’s findings, as our friends at Progress Texas have noted, 22 of the 30 counties nationwide that will benefit most from the Affordable Care Act are here in Texas. The 30 counties were selected because they had some of the highest rates of uninsured people and some of the worst health-related outcomes. A Texas Tribune report on the study mentions that about 40 percent of Texas’ uninsured, more than 1 million people, are expected to receive coverage next year through the health insurance marketplace. Most will get tax credits to help them pay for that coverage, too.
Phillip Martin from Progress Texas says each of the 22 Texas counties that will benefit the most have a population over 25,000:
Burnet ♦ Cameron ♦ Cherokee ♦ Cooke ♦ Dallas ♦ Ector ♦ El Paso
Henderson ♦ Hidalgo ♦ Hopkins ♦ Kerr ♦ Matagorda ♦ Maverick ♦ Navarro
Polk ♦ Potter ♦ Starr ♦ Titus ♦ Val Verde ♦ Waller ♦ Webb ♦ Wharton
Today, the House of Representatives is expected to vote for the 40th time to repeal the Affordable Care Act. But this is no time to refight old political battles. We need to look forward and focus on helping Texans get the coverage they need.
Written By: Laura Brubaker, Engage Texas
Because the governor is hesitant to expand Medicaid, the legislature will probably adjourn without taking full advantage of the dollars available to Texas to cover the uninsured through the Affordable Care Act. Fortunately there is more than one way to skin a cat, which in this case means a way to pull down all the dollars in the affordable care act through a market solution rather than by expanding traditional Medicaid, and it can be done before the legislature meets again in 2015.
Here’s how it would work. The Affordable Care Act divides the uninsured into three groups: 1) those who can afford health insurance; 2) those who can afford private health insurance with sliding-scale premium assistance; and 3) those who can’t afford health insurance. The act assumes that a state will enroll those who can’t afford health insurance in traditional Medicaid (drawing the line on affordability at those with incomes below 138 percent of the poverty level), but it doesn’t have to work that way.
The federal government negotiated an alternative plan with Arkansas that allows that state to take the federal dollars it would have gotten from enrolling its eligible citizens in traditional Medicaid and instead use those dollars to buy them private health insurance coverage. state Rep. John Zerwas, a medical doctor from Houston, proposed legislation to create a similar “Texas Solution.” While his proposal was approved in committee, it was not scheduled for a vote by the House, even though a majority apparently favored the idea.
Going forward, though, nothing stands in the way of our state leaders from striking their own deal with the federal government. Texas law provides all the authority our leaders need. Making a deal would be good for Texas.
More than a million Texas citizens could gain coverage, including more than 800,000 working Texans. This number includes young adults, but it also includes older adults who will not qualify for Medicare for years. And it includes more than 66,000 uninsured Texas veterans and their spouses.
This brings me to a problem you may not have heard about. Last summer, when the United States Supreme Court held the Affordable Care Act constitutional, it threw a wrench into the way the act works by also ruling that the federal government could not impose a penalty on states that chose not to expand Medicaid.
But act’s sliding-scale premium assistance is only available above the poverty line. If a state like Texas doesn’t already cover adults up to the poverty line and doesn’t expand Medicaid, then the state creates a terribly unfair coverage gap. Starting in 2014, those living from 100 to 138 percent of poverty can get sliding-scale premium assistance, while those living below 100 percent of poverty who don’t already qualify for Medicaid get nothing.
In Texas, if you are an adult, chances are you don’t already qualify for Medicaid. Texas Medicaid basically covers only low-income children, seniors, people with disabilities, and pregnant women. Only adults raising children and making less than $4,000 a year (for a family of three) qualify for Medicaid. Working age adults without children do not qualify at all.
This coverage gap creates a big problem for employers. If Texas chooses not to cover everyone up to 138 percent of poverty, Texas employers will pay higher taxes in 2014 because the Affordable Care Act taxes employers who don’t provide health benefits if their employees make between 100 and 138 percent of poverty and sign up for premium subsidies. The Jackson-Hewitt Tax Services estimates Texas businesses will pay $299 to $448 million each year in extra tax penalties for these workers if our leaders don’t provide a Texas Solution.
Finding a Texas Solution to fully implementing the Affordable Care Act would not only help employers, it would bring a projected $6 billion a year in federal funds to Texas communities, build the health care work force and reduce the need for local property taxes to fund indigent care.
Experts project it would also create up to 300,000 jobs, which is why 20 Texas chambers of commerce, the Texas Conference of Urban Counties, and the Texas Association of Business all supported a Texas Solution.
Fortunately, we can afford to develop a Texas Solution at little to no additional cost by shifting current costs to the federal tab and bringing in new revenues from increased business activity.
For the sake of Texas, our leaders need to make a deal with the federal government to fully implement the ACA through a Texas Solution that provides Texas citizens the health insurance they need.
Written by Anne Dunkelberg, Center for Public Policy Priorities. Cross-posted from Better Texas blog.
You’ve been hearing a lot from us about expanding Medicaid, but at this point in the legislative session it is pretty clear: Texas won’t be doing what other states are and enroll more people in Medicaid.
Still, the state legislature has the opportunity to cover 1.5 million Texans who will otherwise have no insurance next year. HB 3791 by Rep. John Zerwas (Ft. Bend) could give Texans that chance. No, it’s not Medicaid Expansion, but it takes action to make sure that low-income Texans will have health coverage available. This bill is headed to the full Texas State House very soon and we want it to pass.
As our friends at Texas Impact point out, although the bill does not expand Medicaid:
It would use newly available state and federal funds to provide private insurance to low-income adults. These adults are pre-school teachers and eldercare attendants, farmers and bakers, cashiers and truck drivers. They work hard for Texas, and they need health insurance. HB 3791 could help more than 1 million Texans get covered.
This is a critical time, and we are asking every Texan who cares about this issue to make a call to their Representative in the House right away. Say, “I’m your constituent. Please support HB 3791 and health coverage for Texans.”
Written by: Mimi Garcia and Laura Brubaker, Engage Texas
I took a dive this morning into just-released new Census numbers on uninsured in Texas and the nation for 2011. Sorry for the blizzard of numbers, but I’ll try to make them paint a picture!
No surprise, Texas still has the worst uninsured ranking in the country, with 6.08 million uninsured (23.8% of all Texans). This is a teeny bit better than last year’s 24.6% uninsured rate—just barely “statistically significant.”
But the picture remains brighter for Texas kids, whose uninsured rate is stable at 16.3% of kids under age 19 (1.2 million uninsured Texas kids). Only in Texas could we celebrate moving to 49th from last place, but Nevada has now solidly claimed the worst-kids’-coverage spot with their 19.3% child uninsured rate.
Of course, 1.2 million uninsured children is nothing for Texas to applaud—we have about 9 uninsured children for every one in Nevada.
Another interesting factoid: of our 1.2 million uninsured Texas children, around 740,000 are children under the CHIP income cap who are either US citizens or legal residents. That means—you guessed it—they could be enrolled in Medicaid or CHIP, but they aren’t! So, clearly we still have loads of work to do educating Texas parents about their options and making it easier than ever for eligible kids to get care and keep their care.
Forgive me if I can’t resist talking a little bit about our Texas parents who lack health coverage. Texans are much less likely to get health care through their job (or spouse or parent’s job) than in the US as a whole. Barely over half of Texans are covered this way 50.6% (compared to US 55.1%). And, working-age adults here have an uninsured rate that is nearly twice what our kids face: 30.9% or nearly one in three adults 19 to 64. The why is simple; Medicaid and CHIP are there for our poor and low-income kids, but Texas adults don’t have those options.
Other signs on my deep dive of the importance of Medicaid and CHIP for children: both the number and percentage of Texas kids with private insurance has dropped in the last four years, but the number and percentage of kids with Medicaid and CHIP has taken up the slack. The only group of Texas children whose uninsured rate went up was those kids just over the CHIP limit, in families between 200-300% FPL.
There is some good news about “really big kids, ” too: uninsured rates improved significantly for Texans 19-25 since 2010, who now have new options to stay on a parent’s health plan until they hit their 26th birthday. You can really see the impact in the numbers, because the uninsured rate for Texas adults 26-64 did not improve at all.
O.K., time to dive back into the numbers again. Stay tuned for an update on how Texas uninsured would fare under the ACA’s private and public health coverage options in 2014!
Written by: Anne Dunkelberg, Center for Public Policy Priorities