We’ve always known that Texas would be a huge beneficiary of the Affordable Care Act because of our huge volume of uninsured people, but this quantifies it in a way that really brings it home.
It’s constitutional – deal with it
Texas is home to more than two-thirds of the nation’s 30 counties most in need of expanded health insurance coverage, according to a liberal group.
The Center for American Progress Action Fund ranked 22 Texas counties – including Dallas — as among the “30 worst” in the country, citing residents’ lack of insurance and poor health outcomes, such as heart attack deaths.
In a report released Thursday, the advocacy group said many Republican U.S. House members “are doing everything they can to torpedo” the federal health law despite having many constituents who would benefit from new state health marketplaces that will open on Oct. 1.
Dallas County, with 31 percent of residents uninsured, had the 14th-worst rate of health coverage among U.S. counties with more than 25,000 people, the report said.
Forty-five percent of Dallas County’s young adults — ages 18 to 39 – lacked insurance in 2011. Nine percent of all county residents have diabetes, which is a rate 13 percent higher than the national average, the group found. Nearly 15 of every 100,000 county residents die each year from stroke. That rate is 26 percent higher than the national average.
“There are just enormous human and economic inefficiencies from [having] a large number of uninsured persons in any county,” Tom Perriello, the group’s chief and a former Democratic congressman from Virginia, said in a media conference call.
While several of the Texas counties on the worst list are along the U.S.-Mexico border, the 22 were scattered in all regions of the state.
The report is here and the summary of it is here. What they did was rank the counties on six different factors:
- Highest overall percentage of uninsured individuals under age 65
- Highest percentage of uninsured women under age 65
- Highest percentage of uninsured individuals ages 18 to 39
- Highest percentage of uninsured young men
- Highest percentage of uninsured people of color
- Highest percentage of uninsured working-class individuals
The “bottom 30” list was then taken from the counties that did the worst overall on all six factors. Harris County scored among the worst on “Highest overall percentage of uninsured individuals” (#19, 29.9%); “Highest percentage of uninsured women under age 65” (#18, 28.8%); “Highest percentage of uninsured individuals ages 18 to 39” (#40, 43.1%); and “Highest percentage of uninsured working-class individuals” (#9, 34.2%), where that is defined as “individuals between 18 and 65 earning between 138% and 400% of the Federal Poverty Line”.
The good news is that despite the Republicans’ staunch refusal to do anything about this problem (with some honorable exceptions including county leaders and a few legislators like Rep. John Zerwas, who detailed his frustrations in this interview with the Observer that you should read), Texas will still get a great deal of benefit from the insurance exchanges. According to a report by the Society of Actuaries, Texas’ uninsured rate could drop from 27% to just under 15% if all eligible people take advantage of the exchange and the subsidies available to them; expanding Medicaid would have dropped that number to 10%, with the remainder basically being undocumented immigrants. This requires that people know about the exchanges and the subsidies, and fortunately there are various efforts underway to make that happen, since the state of Texas isn’t doing anything to help. If all goes reasonably well, many Texans could be a lot better off in another year.
Of course, there remain those who hope that nobody is any better off after the ACA kicks in.
Conservative analyst John Davidson of the free market-oriented Texas Public Policy Foundation said the liberal group – and writers of the federal law – ignore Census Bureau data showing that nearly 1 million of Texas’ 6 million uninsured residents make more than $75,000 a year.
“They have the means” to buy coverage, he said. “They don’t see the value in it.”
He said the Affordable Care Act’s success hinges on whether young, healthy adults will be prodded to buy coverage, which will “subsidize older, sicker people. Proponents of the law are going to be surprised how few young people are willing to take that deal,” Davidson said.
Yes, I’m sure that a privileged old guy like John Davidson knows exactly how people with whom he has nothing in common and for whom he has no empathy will behave. He’s just rooting for his preferred political outcome. Let’s see how good he is at making predictions after we get some data on this, shall we? Progress Texas, Health Zone, the Trib, and Kaiser Health News have more.
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