New Poll Confirms Lack of Health Insurance Harming Texans

A poll recently published by the Episcopal Health Foundation is the latest evidence that the lack of access to health insurance in our state is hurting Texans. The survey results come just weeks after Census Bureau data showed that Texas has the worst uninsured rate in the nation, far worse than neighboring states that have implemented Medicaid expansion.

The poll found that, among Texans under age 65, uninsured adults were more likely to skip or postpone some sort of health care because of the cost (85 percent) compared to adults with health insurance (65 percent). 

The poll also shows that Texans are much more likely to have a primary care provider if they have health insurance. A total of 66 percent of uninsured Texans under age 65 said they do not have a primary care doctor or provider they usually see for regular check-ups, when they are sick, or when they need health advice, compared to just 21 percent of Texans with health insurance. In other words, uninsured Texans were three times more likely than insured Texans to try to make do without a primary care doctor or provider.

The new poll is consistent with past research showing that when people have insurance, they are healthier and less likely to die prematurely. Uninsured individuals typically must wait longer to seek medical care, leading to worse health outcomes and higher costs for families and taxpayers. According to one estimate, just during the three-year span from 2014 to 2017, nearly 3,000 Texans age 55-64 died prematurely because Texas didn’t implement Medicaid expansion.

While there is a valuable patchwork of services for the uninsured in Texas, including community health centers, these clinics typically offer only preventive and primary care services. Other services — such as cancer treatment, kids’ eyeglasses, support for chronic diseases, and specialty care — are often available only to Texans with insurance. Access to even preventive and primary care is often limited because charity providers simply can’t keep up with demand and don’t offer their services at all in a number of counties, especially in rural areas.

Given the state’s high uninsured rate and the importance of health insurance, Texas leaders should make health coverage a priority. There are a number of steps state leaders can take, including:

  • Implement Medicaid expansion to provide an affordable health insurance option to adults with jobs below the poverty line.

  • Reduce delays in processing Medicaid applications for children and other Texans within the state’s narrow eligibility guidelines.

  • Improve the current Medicaid “unwinding” process to ensure that eligible Texans remain enrolled and Texans who are no longer eligible are transferred to other programs.

  • Approve bipartisan legislation by Reps. Bucy, Harless, Oliverson, Jetton, and Bonnen to use already-verified information to create an “Express Lane” option that facilitates health coverage enrollment for currently eligible kids. The bill passed the Texas House overwhelmingly in the 2023 session but did not receive a Senate hearing.

  • Ensure robust Medicaid outreach that addresses concerns of mixed-immigration-status families, including families for one in four Texas kids. Texas can’t enroll all eligible children without it. (Note that undocumented immigrants are NOT eligible for Medicaid.)

  • Ensure meaningful language access to Medicaid/CHIP by making applications, notices, and outreach materials available in multiple languages, not just English and sometimes Spanish. 

  • Effectively implement HB 12 in early 2024 so that Texans enrolled in Medicaid for Pregnant Women can keep their health insurance for 12 months after their pregnancy instead of two months.

We look forward to working with Texans to make sure our state leaders move forward with these proposals.