Texas ranks last for healthcare affordability and accessibility

State & Regional
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A new study ranks Texas as the state with the worst health care system in the U.S. when it comes to accessibility and affordability. 

The Common Wealth Fund, a nonprofit group based in Washington D.C., found 26 percent of working-age adults in Texas do not have health insurance. The state’s uninsured rate is nearly 10 percent higher than the national average but it is an improvement.

Down from 30 percent the previous year, the study reports Texas, like all of the states in the U.S., showed lower uninsured rates after the Affordable Care Act went into effect.  

Overall, the state’s healthcare performance improved but Texas still has the greatest number and the largest percentage of people who do not have health insurance.

“It’s disappointing but not surprising,” said Dr. Theresa Willis.

A pediatrician with the Austin Diagnostic Clinic, Dr. Willis said where you live matters when it comes to healthcare.

“If you live in west Texas you may have to drive a significant distance to see a pediatrician or a family practitioner,” Dr. Willis said.

The study found 64 percent of Texas children 19 and 35 months-old received all their recommended vaccines — down 8 percent from 2013.

 “They’ve never seen polio.  They’ve never seen a child with measles,” Dr. Willis said. “They don’t have that present fear.”

The U.S. has done so well vaccinating against those diseases that Dr. Willis said they are rarer, but she warns that could change if vaccination rates continue to drop.

“Those disease are still out there.  We still see those cases,” Dr. Willis said. “A very real concern is that those diseases are going to make a comeback.”

The pediatrician said vaccines are safe and effective, but she believes access to care and misinformation from “pseudo research” are the reasons behind the declining vaccine rates; not cost.

The Children’s Health Insurance Program helped change the picture of access to care for kids from low-income families in Texas.

“But we don’t have anything for the working-poor parents in Texas.  They are left out of the marketplace because states were supposed to do Medicaid for them and our state hasn’t,” said Anne Dunkelberg, Associate Director at the Center for Public Policy Priorities.

The Affordable Care Act was written under the assumption that every state would offer Medicaid to adults who live below the poverty line. In 2012, the Supreme Court ruled the federal government could not punish state that did not participate.

Dunkelberg said, “So, you end up in this crazy situation where the parents in a family of four earning $25,000 have this great subsidy in the market place.   They are paying maybe $40 a month to cover both parents. But their next-door neighbors who earn $1,500 less, the poorer family, they don’t have any help because the marketplace is only set up to serve people above the poverty line.”  

According to CPPP, Texas is one of 19 states that has not pursued Medicaid expansion or an alternative program to offer care to low-income adults.

Dunkelberg said the state’s uninsured rate impacts everyone.

“All of us pay higher local taxes because that’s really where the buck stops.”

People who go to emergency rooms with a legitimate medical emergency have to be taken care of, so hospitals and local governments must make up the cost difference when an uninsured person is treated.

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