Uninsured and underinsured

Michael Flores looks at a stack of medical bills he received after being flown to St. David’s HealthCare system in Austin for emergency treatment in June 2018.

A higher percentage of Texans are uninsured than in any other state in the nation, and the uninsured rate is getting worse, according to Census data released this month.

More than 5 million went without health insurance coverage last year, or about 17.7% of Texans. That’s more than twice the national average of 8.5%, according to the Census Bureau.

Public health experts say this presents a major barrier to care because it causes people who have minor symptoms to delay treatment until their conditions are much more severe, and expensive, to treat.

Although most people get insurance through their employers, many Americans get state-sponsored health insurance if they are too young or old to work or if their employer doesn’t offer coverage. Public coverage for adults under the age of 65 often comes through Medicaid, the state insurance for people with low incomes and some disabilities. But the Medicaid landscape is vastly different throughout the U.S. In many states, including Texas, there exists what’s known as a coverage gap: those people who don’t qualify for federal assistance, either because they’re not poor enough or because they don’t have children, but who don’t have enough money to pay insurance deductibles.

In the entire U.S., a third of people who fall in that coverage gap live in Texas.

Most of these people lack insurance because the cost is simply too much: A 2017 research survey found that 45% of adults who did not have insurance said it was because the cost was too high.

Dr. Jeannine Griffin, a pediatrician in Port Lavaca, said she sees adults in the coverage gap every day; they’re usually the parents of the kids she’s treating. For most children, it’s relatively simple to qualify for state-sponsored health insurance. But for their parents, it can be much harder.

“If you’re an adult, you’re not going to the go to the doctor or any place until you’re so sick that you can’t stand it anymore,” Griffin said. “And those people show up in the emergency room, and that’s a very, very expensive way to treat patients.”

Griffin and her husband, Dr. Paul Bunnell, have worked as physicians in Port Lavaca for more than 30 years.

“We really did feel like we could make a difference here,” Griffin said. “I don’t think we could have made a big difference in people’s lives in Houston or San Antonio, where there’s a million physicians.”

Griffin’s father was one of the first physicians to work at Memorial Medical Center. It is the hospital where she and her siblings were born and where her own children were born.

Griffin, Bunnell and other physicians working in Texas are struggling to find ways to care for patients who can’t afford their medical bills without insurance. In Calhoun County, at least one in five people don’t have insurance, although the number may be higher because of the difficulty of collecting data in rural areas.

“Everybody deserves access to care,” Griffin said. “Everybody gets sick, and everybody deserves health care. It’s not something that should be a privilege.”

Ciara McCarthy covers local health issues for the Victoria Advocate as a Report for America corps member. You can reach her at cmccarthy@vicad.com or at 580-6597 or on Twitter at @mccarthy_ciara.

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Health Reporter

Ciara McCarthy covers public health for the Advocate as a Report for America corps member. She reports on insurance, the cost of health care, local hospitals, and more. Questions, tips, or ideas? Contact: cmccarthy@vicad.com or call 361-580-6597.

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