The Health Reform Monitoring Survey (HRMS)-Texas report is based on the HRMS, a national project that provides timely information on implementation issues under the Affordable Care Act (ACA) and changes in health insurance coverage and related health outcomes. The Baker Institute and the Episcopal Health Foundation are partnering to fund and report on key factors about Texans obtained from an expanded representative sample of Texas residents. They have published seven reports in the series:
- "Insurance status of adult Texans and characteristics of the uninsured as of June 2014" (released Sept. 3, 2014)
- "Affordability of Marketplace Plans for the Marketplace Target Population" (released July 8, 2014)
- "The Experience of Texans with healthcare.gov" (released June 11, 2014)
- "The Affordable Care Act and Hispanics in Texas" (released May 9, 2014)
- "Early Effects of the Affordable Care Act on Health Insurance Coverage in Texas for 2014" (released April 14, 2014)
- "The Affordable Care Act and Texas' 'Young Invincibles'" (released March 31, 2014)
- "Were Texans Satisfied with the Cost of Health Care and Health Insurance Prior to the Affordable Care Act?" (released Feb. 10, 2014)
The Rice University/Episcopal Health Foundation press release on the latest report, "Insurance status of adult Texans and characteristics of the uninsured as of June 2014," follows:
HOUSTON – (Sept. 3, 2014) – The percentage of Texans without health insurance dropped after the first enrollment period of the Affordable Care Act (ACA), according to a report released today by the Episcopal Health Foundation and Rice University’s Baker Institute for Public Policy.
The report found that since the opening of the ACA’s Health Insurance Marketplace, the percentage of uninsured adult Texans dropped by a little more than 2 percent. The report estimates 378,000 more Texans had health insurance in June 2014 than in September 2013. The small gain in Texans with health insurance was similar to gains in other states that did not expand Medicaid coverage. However, states that expanded Medicaid experienced the largest reductions in uninsured adults – 6 percent compared with the 2 percent in Texas.
“While the insurance gains in Texas demonstrate that people are enrolling in coverage, Texas is also the state with the highest percentage of uninsured adults in the nation,” said Elena Marks, CEO of the Episcopal Health Foundation and a health policy scholar at the Baker Institute. “That means Texas had the farthest to go in reducing the uninsured rate.”
Even with nearly 400,000 newly insured adults, the report estimates Texas has now surpassed California to become the state with the highest number of uninsured residents.The report found the majority of the remaining uninsured adult Texans are Hispanic and low-income. Half of those uninsured are employed.
“The way to make the biggest improvement in covering the uninsured population in Texas is through Medicaid expansion,” said Vivian Ho, the chair in health economics at Rice’s Baker Institute, a professor of economics at Rice and a professor of medicine at Baylor College of Medicine. “In states like Texas that have not expanded Medicaid, the opportunity to reduce the percent of uninsured adults through the ACA without Medicaid expansion is limited.”
An estimated 20 percent of uninsured adult Texans are undocumented and unable to take advantage of Medicaid or Marketplace plans.
The report is the seventh in a series on the implementation of the ACA in Texas co-authored by Marks and Ho. Today’s report contains responses from 1,595 Texans in September 2013 and 1,538 in March 2014. The survey was developed by the Urban Institute, conducted by the company GfK and jointly funded by the Robert Wood Johnson Foundation, the Ford Foundation and the Urban Institute.
The analyses and conclusions based on HRMS-Texas are those of the authors and do not represent the views of the Urban Institute, the Robert Wood Johnson Foundation or the Ford Foundation.