Health & Science

Uninsured Rate Drops 14% In Texas, But Still The Highest Rate In US

New census numbers released Wednesday show a 3 percent increase in the number of Texans who have health insurance.

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For years, Texas has had the notorious distinction of having the highest percentage of uninsured residents in the entire country. But in raw numbers, California always had more uninsured people, because it has more people in general.

But now Texas is the worst of all 50 states on that metric, too.

"Because California covered so many people this year, they are actually now down to 4.8 million uninsured, whereas Texas is up around 5 million," said Anne Dunkelberg, a health policy analyst with the left-leaning Center for Public Policy Priorities in Austin.

"Unfortunately, it's the number one ranking we really didn't want, of both the highest percentage and the largest number of uninsured among all the states," she added.

The new census estimates show what happened between 2013 and 2014. That's significant because 2014 was the first year people could buy insurance plans through the Affordable Care Act marketplace.

That's pretty much how 700,000 more Texans got covered in 2014, boosting the state's overall insurance rate by 3 percent. (The new uninsured rate is now 19 percent in Texas.)

But 2014 was also the first year that states could use federal funds to cover more adults under Medicaid. California chose to do that and Texas did not.

"I would say Texas is fortunate we improved as much as we did, given that we have essentially left the working poor adults without a coverage option, while ironically, people who make more money have access to generous subsidies for private coverage," Dunkelberg said.

For the poorest adults, the Affordable Care Act proposed that coverage would be provided through an expansion of Medicaid. But that part of the law became optional after the Supreme Court's ruling, and twenty states, including Texas, have refused to implement it.

Democrats in Texas have called Medicaid expansion a sensible solution, because the federal government pays 90 percent of the costs, but Republicans in Texas have rejected it, both for its associations with "Obamacare" and because many of them consider Medicaid to be inefficient and overly bureaucratic.

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