COMMENTARY: Texas needs expanded health care

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Photo by Adam Thomas on Unsplash

JAMES POWELL

AND LEAH KING

United Way of Tarrant County

Texans deserve better health care

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Texas faced a health care crisis long before the COVID-19 pandemic.

The percentage of Texans without health insurance is the worst in the nation. In 2019, about 5 million Texans had no health coverage – 18.4% of residents. This rate is double the national average.

Most starkly, one in five uninsured children in the U.S. lives in Texas.

It doesn’t have to be this way. Texans deserve better health care – and that means increasing access to affordable health insurance.

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The Texas Legislature has the opportunity this year to expand coverage through the Affordable Care Act, which would pull down federal funds to cover 90% of this expansion while insuring over one million more Texans.

Numerous studies, including one recently published by the nonprofit, nonpartisan think tank Texas 2036, found that doing so allows for sweeping coverage increases without increasing budget costs.

It’s important that lawmakers not miss this chance.

Tarrant County has felt the full force of this crisis. Among Texas counties with over 1 million residents, Tarrant County ranks worst in the ratio of residents to primary care providers, dentists, and mental health providers. In 2018, a quarter of our population lived below the ALICE threshold – the income a family needs to cover healthcare, housing, childcare, food, transportation, and a basic smartphone plan.

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These numbers have only worsened since the onset of the pandemic.

United Way of Tarrant County is one of several organizations working to fill these gaps. Since March 2020, we have invested over $5 million to help more than 550,000 community residents meet their basic needs.

But we need the state’s help – Texas legislators need to take action.

Fortunately, there’s a solution at their fingertips.

In fact, the Legislature has not one, but two paths forward: traditional Medicaid expansion, and a waiver option with behavioral requirements (modeled after Indiana’s program). The latter currently has broad bipartisan support in the Texas House.

According to a study by Texas A&M commissioned by the Episcopal Health Foundation, both options would make healthcare available to an estimated 78,600 currently uninsured residents in Tarrant County alone and bring in an estimated $331,508,000 new federal dollars to the county, which would have a profound impact on our local economy.

The latest federal COVID-19 recovery act raises the stakes, offering Texas an additional $3 billion ¬– $6 billion over two years if the state expands coverage.

Between the pandemic, this winter’s energy catastrophe, and ongoing challenges around education and infrastructure, Texas can’t afford to pass up this opportunity.

Texas is a great state; it deserves great health care. Thirty-eight other states, both red and blue, have increased coverage with tremendous outcomes for their people and their economies.

This year, legislators have another shot ¬– their best one yet – to pass a Texas-specific solution that improves Texans’ health and saves us money by bringing our federal tax dollars back to the state.

It’s critical that they take it.

James Powell is Chairman of the Board of the United Way of Tarrant County and Leah King is president and CEO of the agency.