|The people who enrolled in Texas are some of the groups who need health insurance most. According to HHS's report breaking down enrollment statistics by state, 84 percent of the new enrollees in Texas received financial assistance. Fifty-five percent are women. Thirty percent are between 18 and 34 - the young and invincible bracket that will help the marketplace function well. Over one-third are Latino.
But there are the others who couldn't enroll because Rick Perry refused to accept the Medicaid expansion, creating what is known as the Medicaid coverage gap. The gap describes those between a rock and a hard place - they make too much to qualify for Medicaid, but too little to qualify for subsidies on the federal exchange. Because the ACA was supposed to provide Medicaid coverage for this group, the subsidies were never designed to reach them. So when the Supreme Court ruled that states didn't have to accept the Medicaid expansion, millions of people were left vulnerable. Especially in Texas.
"People in the coverage gap are likely to face barriers to needed health services, or, if they do require medical care, potentially serious financial consequences," according to the Kaiser report. "Further, the safety net of clinics and hospitals that has traditionally served the uninsured population will continue to be stretched in these states."
Even beyond addressing the health care needs of those in the Medicaid coverage gap, there is a lot of work to be done in Texas. Texas started out with 6 million uninsured before the ACA, so even even after 700,000+ were actually able to enroll, there remain millions more without health insurance. While the shockingly large Medicaid coverage gap explains part of this, there is a much broader problem.
When open enrollment begins again this fall, there will be an other opportunity to make a significant dent in our staggering uninsured rate. "Myriad factors can contribute to enrollment, so it's important not to oversimplify the data on how many Texans got covered this year," said Mimi Garcia, Texas State Director of Get Covered America. "As the state's largest coalition focused solely on health coverage enrollment, we'll continue analyzing and collecting information to identify both the best practices to replicate during the next open enrollment period and the barriers to enrollment that need addressing. In the meantime, it's important to note that strong coalitions and partnerships and ongoing outreach to the uninsured helped lead to a surge in enrollment in March."