Millions Move Toward a Healthier Texas

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.

Some are parents who pull their children off a sports team, fearing the broken bone that would send their family into a financial tailspin. Some have health problems themselves; they have the collection jar passed at houses of worship to help pay for treatment they need.

One thing uninsured Texans are not is alone. More than 6 million people -- including 1 in 3 working-age Texans -- fall into this category. According to data released this month by the Census, ours is still the state with the most uninsured people. Many employers either can't afford or choose not to offer worker health benefits. And without job-based insurance, too many Texans have not found an option they can afford.

People who have been there can tell you that being uninsured, like having a scary illness, leaves a person feeling vulnerable. The looming threat of a big medical bill leads to financial insecurity and sometimes putting one's health on the line. Skipping preventive care, screenings or treatment a doctor recommends because it's unaffordable can have serious consequences. An estimated 48,000 preventable deaths each year occur among uninsured people in this country.

Getting covered, on the other hand, gives people a sense of control and peace of mind. It means having the confidence that, whatever happens, the care people need is there for them, making it easier in good times to stay healthy and safe and, when illness or injury strike, to have a path to recovery.

This more secure future starts tomorrow for uninsured Texans who can find low-cost insurance options available in the newly opened Health Insurance Marketplace.

Part of the Affordable Care Act, the Health Insurance Marketplace offers a variety of health plans that include all the basics, along with some coverage that was previously difficult to find. Check-ups and prescriptions, maternity care and hospital visits, mental health care and preventive services are all covered in the insurance sold in the Marketplace.

Gone are the loopholes and fine print earlier shoppers encountered in the bad old days of trying to buy insurance. Insurers can no longer discriminate against or deny people coverage based on their past health history or even a current sickness, like diabetes or cancer.

What's more, people get to see a clear picture of the different insurance plans and what they offer, side by side. For those who have questions as they shop, experts are on hand by phone, in person and online at

The help doesn't stop there either. Financial assistance is available on a sliding scale to most Texans coming to the Marketplace. A family of four earning $50,000 would pay as little as $64 per month in Austin, once assistance is figured in. A similar family earning $90,000 would receive a break on costs, too, but less of one.

Knowing about the Marketplace is important for any Texan who wants the security of good health insurance, and that includes parents who need it for their children. Texas has more uninsured kids than any state.

Much of the growth in the uninsured child population has come from children in middle class families. Many of these families earn too much to qualify for Children's Medicaid or the Children's Health Insurance Program and too little to enroll their children in private health insurance. At least that was the pattern until now. With the opening of the Marketplace, a path to coverage opens for all American children, regardless of their parents' income.

Meanwhile, the Texans who already have health insurance they like can keep it. They, too, are protected in 2014 from things like getting dropped by an insurer when they're sick or paying out of pocket for preventive care.

Still, the biggest improvements ahead are for Texans whose only options, up until now, put their health or their finances in jeopardy. For these Texans, the opening of the Health Insurance Marketplace is cause for celebration.

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.