This column was originally published in the Houston Medical Journal on Oct. 20, 2020.
The effects of the COVID-19 pandemic are deep and wide-ranging. From our health to our pocketbooks, there are few people this public health and economic crisis has not touched. The pandemic certainly created new challenges. And in some cases, it exacerbated existing ones. We now have the chance to use innovation and ingenuity to solve new challenges and triumph over the old ones.
Accessing necessary medical care has been difficult for many Texans for a long time. Texas has led the nation in the number and percentage of residents without health insurance. Having insurance improves access to care. With rampant COVID-19-induced job loss, Texas’ uninsured rate is even higher now. A Families USA report estimates that 659,000 workers have become uninsured and lost their employer-sponsored health care coverage from February through May alone. The report estimates that 29% of Texas adults under age 65 were uninsured in May. That’s about 5 million people who cannot meaningfully access affordable, comprehensive health care services.
Our nation’s health and financial future has not been in a state this perilous since the pandemic of 1918. If ever there was a time for Texas to increase access to health care coverage, it is now.
Beyond the obvious health benefits, there also are major economic benefits for doing so. The Kaiser Family Foundation estimates that nearly 1.8 million non-elderly Texans, who were uninsured before the pandemic, could be covered in 2021 if the state expanded Medicaid. With coverage expansion, hospitals’ costs of caring for uninsured patients could decrease, and homeowners’ property tax burden could follow.
When the cost of caring for so many uninsured individuals gets shifted onto the private market, it causes unnecessarily high insurance premiums. With coverage expansion, policyholders’ private insurance premiums could be lower. With coverage expansion, more Texans could get the care they need when they need it. And we would have a healthier, more productive workforce to help strengthen the state’s economy. Clearly, the benefits of implementing coverage expansion to the state, its counties, cities, businesses, hospitals, property taxpayers, those with private insurance, and those without it are significant.
And likewise, the cost of limiting access to care also is high. Under federal and state law, Texas hospitals must provide emergency treatment and stabilization services to anyone, regardless of their ability to pay. This means that every year, hospitals across the state accrue $4.5 billion a year in unreimbursed costs.
Whether by using health insurance for preventive care to maintain good health, reducing reliance on emergency departments, and hospitals’ charity care to treat unmanaged chronic conditions, Texans will always need health care services. That is undeniable. How and whether those services are covered is negotiable, and there is much room for improvement. Providing a path to that care, it will make Texas and its residents physically and economically stronger. If necessity is the mother of innovation, now is the time to increase health care coverage options.