Some six million Texans are one health emergency away from financial ruin, and the state of affairs in Dallas County isn't any better. Nearly 30 percent of its residents are uninsured.
That's 672,681 of our neighbors whom the health insurance markets have excluded, according to the latest U.S. Census Bureau numbers.
That number could be cut drastically with the full implementation of the Affordable Care Act, derisively known as Obamacare to its opponents, according to a recent report from a couple of demographers out of Rice University. In fact, in Texas the ranks of uninsured would be halved by 2014, even while allowing for undocumented immigrants, who aren't eligible, and for moderate enrollment. In Dallas County, the uninsured would shrink from 28 percent to 14 percent. That means more than 300,000 previously uninsured neighbors of ours could get health insurance. But Governor Rick Perry says that won't happen on his watch.
"Neither a 'state' exchange nor the expansion of Medicaid under this program would result in better 'patient protection' or in more 'affordable care,'" he wrote in a statement. "They would only make Texas a mere appendage of the federal government when it comes to health care."
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This comes from the governor of a state with the highest percentage of uninsured people, and the decision has been left to him. One of the consequences of the U.S. Supreme Court opinion on ACA is that it leaves the expansion of Medicaid for adults to the state's discretion. Since Perry has decided to opt out, you might as well cut the potential gains in Texas and in Dallas County by half, the researchers say, excluding the poor adults who are among those who need coverage the most. Meanwhile, higher income families would continue to have their private insurance subsidized.
"...the number and the socio-economic profile of the Texans who will gain coverage could vary dramatically depending on the decision made by Texas elected officials on Medicaid expansion," they write.
Either way, we pay for the uninsured. We pay when they show up in the emergency room with an untreated and out-of-control ailment. We pay when the hospital writes off what they can as bad debt. And we pay when our insurance rates go up because the hospital needs the extra revenue from the insurer or from the county in the form of local taxes. So the cycle continues, pushing health insurance further and further from the grasp of those who could not afford it to begin with.
Without the Medicaid expansion, the entire purpose of the ACA is defeated. Which, let's face it, must make Perry very, very happy.