Though the Affordable Care Act has helped over 700,000 Texans get health insurance coverage thus far, there are many poor Texans who aren’t getting covered thanks to the state’s refusal to expand Medicaid. In fact, Texas has one of the highest populations stuck in what’s called the “coverage gap”: making too much to be eligible for Medicaid, but making too little to qualify for subsidized private insurance. Had the state expanded Medicaid, these people would have been covered, but for now, over 1 million Texans are being left uninsured.
A new study from the Kaiser Family Foundation shows just how bad the coverage gap is. For those in states that are expanding Medicaid, people are covered if they make up to 138% of the federal poverty level per year. For a family of three, this means making $27,310 or less will qualify you for Medicaid coverage. In comparison, “Medicaid coverage in Texas is cut off for parents earning above 19 percent of the federal poverty level — or $3,760 for a family of three.” Any income higher than that scant amount leaves parents in the lurch when it comes to receiving Medicaid coverage for themselves. The threshold increases slightly for having more than one child, but it is still very low overall.
Among the states not expanding Medicaid, only one state has a lower cutoff than Texas: Alabama.
The Kaiser study also highlighted how bad the situation is for childless adults seeking coverage. Save for Wisconsin, no state that refused Medicaid expansion offers full coverage for childless adults. The minimum required income to receive subsidized healthcare on the marketplace is 100% of the federal poverty level. For childless adults making anything less than the federal poverty level, full Medicaid coverage is simply out of reach.
The chart below, from the Kaiser Family Foundation’s report illustrates how little coverage Texas provides compared to the other states who are not expanding Medicaid. (While also illustrating that many of those states aren’t much better, either.)
In total, the report found that there are about 4 million individuals in the US who are stuck in the coverage gap due to their states’ refusal to expand Medicaid. And Texas leads the pack, with its 1 million people who are struggling to get access to care.
The only good news for Texans is that there is talk that Greg Abbott may be finally be considering options to expand Medicaid. As we reported last month, Abbott has reportedly been looking at a state-specific compromise that Utah made to expand its Medicaid, and considering how that would look in Texas. If he were to go through with it, over a million Texans would benefit, especially those parents whose meager incomes are currently making them “too rich” for Medicaid. Let’s hope that Abbott decides to bring Texas forward, instead of purposely leaving poor Texans behind for the sake of political benefit.