Legislators file bills to expand Medicaid as Texans struggle to access affordable health care

Lauren Abel

Texas legislators proposed bills to expand Medicaid and address the state’s health insurance disparities as more than 5 million Texans continue to weather the COVID-19 pandemic uninsured.

Approximately 750,000 to 1 million Texans fall into the coverage gap, an income region where people earn too much money to qualify for Medicaid, but too little to receive financial assistance for private insurance through the Affordable Care Act (ACA), according to Every Texan. The ACA originally contained a provision requiring states to expand Medicaid, but a 2012 Supreme Court case ruled the expansion unenforceable.

Texas is one of 14 states that has not voted to expand Medicaid, according to healthinsurance.org

“A key function of the Affordable Care Act is giving states the opportunity to ensure more of their own residents are insured,” said Celia Israel, Texas Representative for District 50. “These are people who, if they don’t have insurance, are one accident away from losing their job and their livelihood.”

Israel introduced House Bill 389, one of many bills proposed during this legislative session aiming to expand Medicaid under the federal Patient Protection and ACA. 

Philosophy freshman Jocelyne Covarrubias said as a minor, she was covered by Children’s Medicaid. Once she turned 18, she was forced to refile under the more restrictive Healthy Texas Women plan, which only offers women’s services. 

University Health Services does not accept Medicaid as an insurance plan for their services, which has made it more difficult to access care, Covarrubias said. 

“(UHS) was charging me $10 for each visit,” Covarrubias said. “If something were to happen to me, as much as it sucks to say this, I don’t think I’d really be so much concerned with my health, I’d be more concerned about the cost of everything.”

Although most Democrats support Medicaid expansion, most Republican legislators have opposed expansion for years. Texas Senator Charles Schwertner said in a public hearing during the 85th legislative session that the provision in the ACA is misleading and would do little to remedy coverage issues. Schwertner did not respond to a request for comment.

“You deserve the right to make your own healthcare choice, and no government has the right to interject itself between you and your doctor,” Schwertner said on his website

David Warner, professor of health and social policy at the LBJ School of Public Affairs, said Medicaid is typically only accessible to children, pregnant individuals or people with disabilities. Warner said the expansion would be financially beneficial for hospitals and the state.

“If (states) signed up for Medicaid, the (federal government) picked up 90% of the costs,” Warner said. “There’s no way it wouldn’t have been profitable.”

Warner said the ACA currently makes Medicaid coverage difficult for college students, who may be eligible to receive low-cost insurance from their school.

Psychology freshman Linda Treviño said she never knew she was uninsured until she came to UT. Treviño said finding information on low-cost clinics, their pay rates and qualification criteria for services is difficult. 

“I used to live on the border so if I ever needed a doctor’s help, I would go across (the border) instead of getting help (in the U.S.),” Treviño said. “Now that I live in Austin … I can’t just go anywhere and ask for help without facing a large bill.”