Texas is still struggling to catch up with the rest of the country when it comes to health care coverage. A new report tracks two years of data, from September 2013, before the online marketplace opened, to September 2015.
During that time, the uninsured rate among nonelderly adults in Texas dropped from 23.5 percent to 18.5 percent.
That decrease in Texas is only half as large as the national decrease in uninsured people – across the U.S., the uninsured rate is now 10.4 percent of the population.
The report, part of the ongoing Health Reform Monitoring Survey, was co-authored by Elena Marks and Vivian Ho, both scholars at Rice University's Baker Institute for Public Policy.
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"Texas didn't compare quite as well. Our rate of uninsured population did drop substantially and that's really good news, but it didn't drop nearly as much as the average across the U.S.," said Elena Marks, who is also CEO of the Episcopal Health Foundation in Houston.
Older Texans, those between age 50 and 64, saw bigger gains.
Before the Affordable Care Act, older adults were often charged much higher premiums for their coverage in the individual health market. But the health law limited how much insurance companies could change premiums based on age.
Older Texans took advantage of the new rates, and their uninsured rates dropped by a third.
Hispanic Texans also benefited from new coverage options, Marks said.
About 40 percent of Hispanics in Texas were uninsured two years ago, that has since dropped to about 30 percent. Nevertheless, that demographic is still the most uninsured group in Texas.
Marks emphasized that state leaders could help move the needle further by expanding Medicaid for the poorest people. But that part of the law was rendered optional by the U.S. Supreme Court. Republicans in Texas and elsewhere have chosen not to expand Medicaid to more adults, and have attacked it as an inefficient public entitlement.
But even without a Medicaid expansion in Texas, subsidized insurance is still available through the online marketplace for middle-class Texans and some low-income ones, as well. Most people who apply will qualify for tax credits to pay for their health plans.
Almost three million Texans are eligible but have not yet signed up.
The final deadline is January 31.