Deep in the Uninsured Heart of Texas

Everything is bigger in Texas: the trucks, the hats, the steaks, and the number of people without health insurance. As the uninsured capital of the United States, Texas has nearly five million people without health insurance.

Health care is political for corporate lobbyists, who spend fortunes influencing legislation and regulation of their industries. It’s political for representatives, who serve donors over constituents to be reelected. It should be political for people who fundraise online to survive their diagnoses.

Health care is a collective concern because costs are shared collectively. Costs for uninsured people are folded into premiums and costs for care for everyone — and each year, lost earnings and poor health for uninsured people takes $70 billion out of the state economy.

Health insurance isn’t the same as coverage and access. Medical debt remains the most common cause of bankruptcy. In the United States, three out of four people can’t financially withstand a medical diagnosis and even people with insurance can’t always access or pay for care.

Every day, Texans make choices to take their children to the doctor or to wait, whether to pay medical bills or rent, and whether they can afford the treatments that they need, not only to survive but to thrive.

Many wait until an emergency to seek care. What many don’t know, however, is that hospitals are only required to stabilize people without insurance: not to treat, cure or prevent deterioration. But people don’t just need sick care, they need health care.

The Texas Workforce Commission (TWC) reported that January marked 105 consecutive months of annual job growth. If the state is experiencing consistent job growth, why isn’t the health insurance gap closing?

For starters, Texas has roughly 60 percent labor force participation and the oversimplified unemployment rate doesn’t include nearly half of the state eligible for work or those underemployed in gig economy work without benefits. It also doesn’t include the nearly 250,000 people in the state’s jails.

Texas rejected the federal Medicaid expansion in the Affordable Care Act (ACA). Many who would qualify for Medicaid in another state cannot get access to low-income health care as a result.

Another 400,000 children of working families that don’t qualify for Medicaid will likely lose coverage this year. In 2018, Congress defunded the Children’s Health Insurance Program (CHIP) with no replacement and short-term federal funding will only carry the program through March 2019. Texas already leads in uninsured children, and addressing the threat of one million Texas children without access to health care should be a top priority for representatives.

Without health, children cannot learn. Without access to comprehensive care, children with learning and developmental disabilities, physical conditions, and other health concerns are going undiagnosed and untreated.

There’s a deep-rooted fear of government involvement in health care. And yet corporations have control of insurance — what it costs and what it covers — and make themselves richer while we get sicker. The U.S. pays the highest costs for care in the world for some of the worst health indicators among developed nations.

We need to close the uninsured gap. Every other developed nation in the world has done it. The private insurance industry is entrenched in the financial relationship between lobbyists and lawmakers. Elected officials and their corporate donors have power and power concedes nothing without demand.

If we are going to join nearly 60 percent of the country supporting Medicare for All, we must build the power to demand health care as a human right.

This article was published in The Fort Worth Weekly.