Health care

On Tuesday, Texas will lead a group of 20 states in a legal challenge to the Affordable Care Act, the 2010 law that remade the U.S. health care system and has provided health insurance coverage for thousands of people in the Crossroads and millions in Texas.

Opinions about the ACA, also known as “Obamacare,” are still mixed, largely along party lines. Although overall opinions of the act tend to vary by political party, many of the law’s core tenets are popular with voters in both major parties, particularly the law’s protections for pre-existing conditions. Prior to the law, people with health conditions like diabetes, substance use disorder, and heart disease could be denied coverage or charged more if they tried to get health insurance outside of their jobs, according to the Kaiser Family Foundation.

But the law has remained controversial among Republicans, in part because of an ideological opposition to the federal government exerting additional control over the U.S. health care system. And although the law has allowed millions of Americans to be able to pay for their medical care, some people have seen their health costs increased as insurers raised their prices, particularly those people who earn too much money to qualify for tax credits to help pay their insurance costs.

Texas’ attorney general is leading this most recent challenge to the law. Oral arguments in the case are scheduled for Tuesday, and the Supreme Court is expected to issue a decision in the case sometime before next June.

The law has dramatically changed the U.S. health care system, and affects almost every American in some form, said Cynthia Cox, an ACA expert. Cox, who is also a vice president with the nonprofit Kaiser Family Foundation, said that if the law were to be completely thrown out, it would thrust the U.S. health care system into “chaos.”

Legal experts think it’s unlikely, although still possible, for the court to throw out the law in full. If the court opts to overturn the entire law, the health care system in the Crossroads and throughout all of Texas would change dramatically.

In Texas, one of the most significant changes brought about by the law was the creation of the individual insurance marketplace, said Jennifer Knoulton, the vice president of Regional Operations for Methodist Healthcare Ministries.

The marketplace offers a place where individuals can buy their own insurance plans if they aren’t able to get health insurance through their jobs, or through a public insurance program like Medicaid or Medicare.

“We know that most bankruptcies for individuals are caused by health care bills, and we know that having insurance and access to care is the way our health care system runs in this country,” Knoulton said. “So by having the ACA and providing the opportunity for people to select insurance and be covered be covered not only getting that preventive care that helps prevent some of those disease.

Last year, 1.12 million Texas enrolled for health insurance coverage through the marketplaces, Knoulton said.

“As the pandemic economy has demonstrated, people can lose job-based coverage at the drop of a hat,” Cox said during a public briefing on the Supreme Court challenge. “And before the ACA it was very difficult if not impossible for many people to maintain coverage if they lost their jobs.”

It’s unclear how many people in the Crossroads may have lost their health insurance when they lost work during the current recession.

Knoulton added that the law’s coverage of preventative care was particularly important in a region like South Texas, where diabetes is prevalent and where catching and treating the disease early is essential to prevent worse outcomes.

Jeannette Flores, an independent insurance agent in Victoria, said she’s worked with dozens of individuals and families in recent years who were able to pay for essential medical care, like chemotherapy, because of insurance they purchased on the marketplace. For customers who are self-employed, don’t get insurance through their job or don’t qualify for public insurance programs, marketplace plans are the only option to cover them in an emergency or if they get a serious medical diagnosis.

Ciara McCarthy covers public health and health care for the Victoria Advocate as a Report for America corps member. You can reach her at or at 580-6597. To support local journalism at the Advocate through Report for America, go to

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Health Reporter

Ciara McCarthy covers public health and health care for the Advocate as a Report for America corps member. Questions, tips, or ideas? Please get in touch: or call 361-580-6597.

(10) comments

Lish Hugsgrizzlybears

Health care is a basic human right. Back in the day- anyone in town could go see their town doctor at a reasonable price. I don't recall anyone going bankrupt or being denied because they were sick already. Of course town doctors weren't driving BMWs and getting 160-270K a year either. They were humble town folks who cared enough to help others out for a humble living. Don't get me wrong- I would rather live in the now where science lives- but I would take easy health care access for those whom most need thy mercy any day of the week. Why not just let them have their mercy? Why deny them all? And why do I need to preach this?

Rick Dockery

The government has zero business in health care period.

Mike Gomez

That’s not true,Rick. “ The Preamble states that an overriding purpose of the U.S. Constitution is to “promote the general welfare,” indicating that issues such as poverty, housing, food and other economic and social welfare issues facing the citizenry were of central concern to the framers.”

Rick Dockery

Life, liberty, and the pursuit of happiness. That’s what we are owed. The opportunity to succeed. The opportunity to fail. The opportunity to help others. We the people, not we the government. Where does it stop? Do we get a house given to us, a car, a phone? Is it really given or taken from another. This country was founded on liberty. We fought the tyranny, and won. Let’s not become one.

Ron Sandidge

That's not right, Mike. The general welfare clause has nothing to do with those situations you state. They were not talked about during that discussion. That is falsehood past on by left with post modernist progressives. Easy to tell by studying the people who wrote it, read the Federalist papers. "It has been urged and echoed, that the power “to lay and collect taxes, duties, imposts, and excises, to pay the debts, and provide for the common defense and general welfare of the United States,” amounts to an unlimited commission to exercise every power which may be alleged to be necessary for the common defense or general welfare. No stronger proof could be given of the distress under which these writers labor for objections, than their stooping to such a misconstruction. Had no other enumeration or definition of the powers of the Congress been found in the Constitution, than the general expressions just cited, the authors of the objection might have had some color for it… For what purpose could the enumeration of particular powers be inserted, if these and all others were meant to be included in the preceding general power? Nothing is more natural nor common than first to use a general phrase, and then to explain and qualify it by a recital of particulars… But what would have been thought of that assembly, if, attaching themselves to these general expressions, and disregarding the specifications which ascertain and limit their import, they had exercised an unlimited power of providing for the common defense and general welfare?" (Federalists #41) Thus we have the run away politicians that we have today.

Mike Gomez

Lol...The constitution is not left or right but you only quote right wing sources...Anyway the interpretation of the “ General welfare clause” has been argued before the courts...Cornell law summed up the clause “ By and large, it is for Congress to determine what constitutes the “general welfare.” The Court accords great deference to Congress’s decision that a spending program advances the general welfare,620 and has even questioned whether the restriction is judicially enforceable.621 Dispute, such as it is, turns on the conditioning of funds.

As with its other powers, Congress may enact legislation “necessary and proper” to effectuate its purposes in taxing and spending. In upholding a law making it a crime to bribe state and local officials who administer programs that receive federal funds, the Court declared that Congress has authority “to see to it that taxpayer dollars . . . are in fact spent for the general welfare, and not frittered away in graft or on projects undermined when funds are siphoned off or corrupt public officers are derelict about demanding value for dollars.”622 Congress’s failure to require proof of a direct connection between the bribery and the federal funds was permissible, the Court concluded, because “corruption does not have to be that limited to affect the federal interest. Money is fungible, bribed officials are untrustworthy stewards of federal funds, and corrupt contractors do not deliver dollar-for-dollar value.”623“

Joyce Drost

Earlier comment posted in error under my sister’s name. Sorry, sorry, sorry. I’m in the process of moving back to Victoria and will be commenting in the future under my real name. Again, sorry, sorry, sorry. - Barbara Domingue

Ciara McCarthy Staff
Ciara McCarthy

Hi Barbara - No worries at all! And thanks for being so respectful of our commenting guidelines. It truly does make for a more respectful and productive discussion when people keep the commenting rules in mind :) Thanks for reading, and welcome back to Victoria! Best, Ciara McCarthy, Advocate reporter

Joyce Drost

WHY is Texas continuing to be led by the nose when it comes to Paxton? Why does he think that killing the ACA, especially now during the coronavirus pandemic, is what the majority of Texans want? This is governing? Wikipedia says that “"Good governance" implies that mechanisms function in a way that allows the executives (the "agents") to respect the rights and interests of the stakeholders (the "principals"), in a spirit of democracy.” Is this what we’re getting from people like Paxton? Are you kidding me? This is all about power, not governing ... keeping the people’s needs under your thumb, not in your sight. Because, if you keep the majority of Texans under your thumb, you — the minority — can stay in charge. Stand by. Change in Texas has started. We’re not done yet. It will take as long as it takes, but Texas WILL change for the better. Your days are numbered.

Grace Butler

I mean, this is Paxton. A literal criminal. As long as he kowtows to the party line, he will keep power and won't go to jail. It's classic corruption. The bigger issue is that voters allow it.

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