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Over One Million Low-Income Texans are Stuck in the Medicaid Coverage Gap

by: Emily Cadik

Wed Dec 18, 2013 at 09:00 AM CST

Read All "12 Days of Enrollmas" posts here.

According to recent analysis from the Kaiser Family Foundation, there are close to five million low-income adults nationwide who fall in the Medicaid coverage gap: people whose incomes are too high to qualify for Medicaid, but too low to get tax credits for coverage in the health insurance marketplace. Over one-fifth of them - 1,046,430 people - live in Texas. Three-fourths are people of color.

Most of the Texans in the coverage gap (70 percent) are either working or working families. Many work for small businesses that are not subject to penalties if they don't offer coverage, and many are part-time workers who are not required to be provided with insurance. Without a Medicaid expansion in Texas, their chances of obtaining health care coverage are just as slim as they were before the Affordable Care Act.

There's more after the jump.  

The health needs of the group in the Medicaid coverage gap are significant and the impacts of not having insurance can be devastating.

According to the Kaiser report:

"While nearly half of people in the coverage gap report that their health is excellent or very good, a fifth report that they are in fair or poor health. These individuals have known health problems that likely require medical attention. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.  When they do seek care, the uninsured often face unaffordable medical bills."

It's a vicious cycle - when people lack health care coverage, they are less likely to be able to manage problems before they become serious. And when the problems become serious enough that they have no choice but to seek medical care, the costs are much higher. This cycle could be avoided if the uninsured could take advantage of the extensive health care coverage that the federal government is willing to provide at essentially no cost to Texas.

Instead, Texas will continue to pay for Rick Perry's refusal to expand Medicaid for years to come. We recently reported that Rick Perry's refusal to expand Medicaid will cost the state $9 billion. That's a lot of money to keep 1 million people uninsured.  

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