Whether we like or not, Obamacare has led to many more Texans being insured than were before the Affordable Care Act. According to a new survey from Rice University's Baker Institute and the Episcopal Health Foundation, Texas had a 24.6 percent uninsured rate among residents 18-64 in September 2013, the highest in the United States. By March 2015, the rate of uninsured had dipped to 16.9 percent, still the highest in the country.
The news isn't all good though. For the first time, the survey's authors say, Texas has the highest raw number of uninsured residents in the country. Additionally, the lowest income Texans are among the least likely to have health insurance.
Most of the drop in uninsured can be attributed to individuals taking advantage the Healthcare Marketplace created by the ACA, according to the survey.Before Obamacare, very few Texans purchased individual health insurance.
"The lowest-income Texans are almost four times more likely to be uninsured than those with higher incomes," Vivian Ho, the chair in health economics at the Baker Institute said in announcing the findings. "This coverage gap has grown since 2013 primarily because the ACA Marketplace allows households above the federal poverty level to buy health insurance using subsidies. Those same levels of discounts are not available to Texans with incomes below the federal poverty level."
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If you make less than $11,670 in a state that's refused the expansion, you're ineligible for the subsidies the ACA provides to help pay premiums, because, you know, you were supposed to be covered by the Medicaid expansion.
"Unless Texas participates in an expanded Medicaid program or develops some other mechanism for covering the lowest income Texans, this is not likely to change," the study says.