Expanding Health Insurance Coverage for Young Texans

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Newly appointed Chairman of the Senate Health and Human Services Committee, Senator Charles Schwertner, held a hearing at the Capitol on the state of health insurance in Texas.

This hearing will set the tone for what’s bound to be a long debate over how to cover millions of uninsured Texans, while managing the cost of health care.

Here’s how we got here, and here’s what you should keep in mind.

More below the jump!

As it stands now, millions of Texans currently don’t qualify for health coverage, and nearly half of them are young adults. The new health care law, or the Affordable Care Act (ACA), was designed with the expectation that states would expand eligibility for Medicaid coverage to cover the lowest income residents. To incentivize that, states can receive billions of dollars to expand coverage for their poorest residents.  For individuals earning slightly more, or those earning above the poverty level ($11,670), the ACA provides financial assistance such as tax credits to purchase a plan.

 But when states – such as ours – don’t expand coverage, the poorest people fall into a “coverage gap.” They can’t get state-based health coverage or financial assistance to buy a private plan. The only low-income Texans to qualify for state-based coverage are pregnant women, disabled adults and parents with extremely low incomes. And this coverage gap impacts young people disproportionately.  As our lawmakers consider the state of health coverage, here are a few things to keep in mind about the impact on this generation:  

The people who find themselves in the health care gap may surprise you. Young adults, veterans and adults with mental health needs are often left out. Living without insurance is a huge financial and health risk for young adults. Over 40% of Texans in the coverage gap are young adults between the ages of 18 and 34 years. But young people absolutely need access to health care: they’re more likely to end up in the emergency room than any other age group, except the elderly. Emergency room care can be extremely costly. Over thirty-six thousand Texas veterans could be left out in the cold and up to 184,200 more people could experience depression, an illness that is especially common in young adults.

  —By not expanding state-based coverage, we punish people trying to move out of poverty, which particularly impacts young people trying to get ahead. Most people who are working part-time can’t qualify for health coverage: a single young adult has to make $11,670 a year to qualify for health insurance tax credits. That means that a community college student, for example, who is juggling higher education and working part-time to pay the bills, is among the most vulnerable.  Low-income students have to make an impossible choice: work full-time to make enough money to qualify for affordable coverage, or go to school and forgo health insurance.  Single parents also have a tough time qualifying under the current state plans. A parent who makes more than $3,736 and less than $19,790 per year, and has two children, is ineligible for state-based coverage or financial assistance.

 —There’s room to get creative. States have flexibility to design a program to fit their needs. Arkansas, for example, expanded coverage by using funds to subsidize the cost of private health insurance plans for low-income adults, rather than add newly eligible adults to their state program.  Texas could create an expansion model that works for our state.    As lawmakers consider next steps, one thing is clear: we need to expand coverage and ensure that we don’t leave young Texans out just as they try and build their futures.

  By Jessica Adair of Young Invincibles


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