Texas ACA

Even with Texas turning its back on the health care exchanges and an expansion of Medicaid as proposed by the Affordable Care Act, about 1.7 million individual Texans have gained health insurance coverage under the controversial federal law.

A new study found the percent of uninsured Texans fell from almost 25 percent in September 2013 to 17 percent in March 2015, with almost the entire decline in uninsured occurring because individuals purchased health insurance subsidized by the federal government. But a pending U.S. Supreme Court case—King v. Burwell—could easily wipe out those gains in paying for healthcare in the state. 

The above map shows the areas of the state where the most people are who have bought insurance on their own. The map, produced by the advocacy group Community Catalyst is hosted by the Texas Center for Public Policy Priorities. People with health insurance are more likely to have a regular physician for minor illnesses and preventative care. The ACA often is referred to as Obamacare.

The new study by the Rice University Baker Institute and the Episcopal Health Foundation found most of the gains in health insurance coverage occurred after the ACA Marketplace opened in September 2013.

Texas had led the nation in the percentage of the population lacking health insurance, and its percentage of people who gained insurance on the exchange was about on par with other states that refused to expand Medicaid eligibility. But for those states that did expand eligibility, the average percentage of their uninsured population dropped from about 16 percent to 7.5 percent.

People with incomes between 139-399 percent of the federal poverty level decreased the percentage of uninsured by 44.5 percent, but the lowest income Texans cut their numbers of uninsured by just less than 20 percent. “The ACA was intended to provide coverage opportunities to the lowest income Americans through Medicaid expansion and without such, these Texans are likely to remain uninsured,” the report said. (Note: 139 percent of the federal poverty level is about $33,465 a year for a family of four.) 

Texas leaders have refused to follow ACA guidelines for Medicaid expansion, claiming it would cost the state and additional $15.6 billion over 10 years. Here is the estimate that was put out in 2013 by the Texas Health and Human Services Commission.

Medicaid expansion

Republicans have repeatedly tried to undermine or overturn Obamacare, but the Washington Examiner reported earlier this week that congressional Republicans are now worried about blow-back in the 2016 elections if millions of Americans lose health insurance when the King v. Burwell ruling comes down from the Supreme Court in the next several weeks. The plaintiffs in the case argue that the text of Obamacare only makes federal subsidies available to people in states that set up health care exchanges for the purchase of insurance. Only 16 states set up exchanges, and Texas is not one of them. An estimated 13.4 million Americans could lose their health insurance subsidy of the Supreme Court rules in favor of the plaintiffs.

The Washington Examiner reported earlier this week that congressional Republicans are looking for a “fix” to keep the subsidies going if the Supreme Court knocks them down.