Texas can’t afford to not expand Medicaid
Everything is bigger in Texas, including the number of patients without health insurance. Our state has 5 million uninsured individuals. That’s almost 1 in 5 Texans who lack health coverage.
Texas is missing out on $11.9 billion in federal funds by not expanding Medicaid. We should take it.
As the Texas House and Senate consider the issues each legislative committee will explore during the 2025 legislative session, they must prioritize the almost 2 million state residents who cannot afford health insurance.
As medical professionals, we care for patients across the state with hypertension who can’t pay for medications, can’t afford to see specialists or must head straight to the emergency room when they’re ill because they are uninsured. Some patients in rural communities who become very sick often don’t have a local hospital to care for them.
We see firsthand how this dire situation leaves countless neighbors struggling to access essential health services. They cannot see a doctor, obtain preventive health screenings or get care for their diabetes or heart disease.
The result is avoidable suffering, exacerbation of treatable and preventable diseases, and loss of life. The reason Texas ranks near the bottom of most major health indicators is because too many working-class residents earn too much to qualify for Texas Medicaid but not enough to qualify for subsidies on the Affordable Care Act insurance exchange or to pay for any other type of health coverage.
Most people in the coverage gap are employed, often in the construction, service or retail industries.
Forty other states fixed this coverage gap by expanding Medicaid to families with higher income levels.
The federal government pays 90% of the costs of closing this gap, which would cover an additional 1.85 million people in Texas. Leading Texas economists estimate closing this gap would actually increase state revenue by reducing expenses for other state welfare programs.
A healthier population generates a more productive and vibrant workforce, creating economic growth. The Perryman Group estimates that if Texas narrows the coverage gap, the state would gain $45.3 billion in gross productivity, $29.4 billion in personal income and almost 461,700 jobyears of employment. This would create $2.5 billion in statewide tax receipts and nearly $2 billion to local governments.
That doesn’t even include the lower costs of care and improved mortality. Expanding Medicaid would greatly benefit our patients, who could obtain preventive services such as cancer screenings.
Some of that extra money should be spent supporting rural hospitals. Even if our patients have health insurance, it doesn’t help if there is no hospital to care for them. Too many communities are now without medical facilities, leaving residents with limited access to critical health resources.
Texas can afford to expand Medicaid and save rural hospitals at the same time. The state has been turning its back on this free money and the added economic benefits of closing the health insurance gap for 14 years.
Our patients can’t afford to wait much longer.
Dr. Fabrizia Faustinella is a Doctors for America Copello Health Policy fellow. Dr. Shetal Shah is chair of the national Pediatric Policy Council. Dr. David Auerbach is an associate professor in the Department of Internal Medicine at UT Southwestern Medical Center in Dallas. Alex Gajewski is a medical student at UT Southwestern.