Texas: Health Care for the Uninsured (Download as a PDF)

The Issue

Although America is the most prosperous nation in the world, the number of Americans without health coverage is staggering—46.6 million individuals or 16 percent of the population. Surprisingly, most of the uninsured are employed. According to the National Center for Health Statistics, approximately 78 percent of the uninsured live in families headed by someone in the workforce. The uninsured are most likely to be low income, in poor or fair health, and employed in small firms. Especially vulnerable are children in uninsured families.

Among the states, Texas leads the nation in the portion of uninsured with 24.6 percent of the state’s population lacking health insurance.

To combat the problem, in 1997 Congress enacted the State Children's Health Insurance Program (SCHIP) and expanded Medicaid to provide health coverage for low-income children. More than $40 billion in new federal funds have been made available to states over the last 10 years. Texas adopted SCHIP legislation in 1999, originally setting the eligibility criteria at an adjusted family income of 200 percent of federal poverty level or less with annual enrollment periods.

In 2003, the Texas Legislature amended Medicaid and CHIP eligibility standards to help combat a $10 billion budget deficit. To foster savings of more than $1.6 billion, the eligibility standards were reduced by establishing a new ceiling of 150 percent of the federal poverty level, enrollees were charged higher premiums, and enrollment periods were shortened. The changes resulted in a drop in enrollment of almost 150,000 children in the span of a year. In 2005, lawmakers restored eligibility for many of those cut from the rolls in 2003.

CHRISTUS worked with the Texas Hospital Association in 2005 to expand the non-capitated managed care approach to administering care for aged, blind and disabled recipients in Texas. We also worked with health care trade associations to amend the Insurance Code to allow hospitals to offer discounts on health care services to uninsured patients.

The CHRISTUS Health Position: Health care for all.

CHRISTUS Health’s ministry is committed to health coverage for all. This commitment is based on Catholic social justice teaching and a mission of service to the poor. For millions of vulnerable persons who do not have access to health insurance, the current health care system lacks accessibility. CHRISTUS Health recognizes that the access to health care coverage for all is a major undertaking; however, the task must begin now.

CHRISTUS Health continues to seek to raise public awareness of the injustice of the inadequacy of health care coverage, particularly with regard to the uninsured, and to help build support for changes especially for children and the working uninsured.

CHRISTUS Health supports adequate state and local funding of Medicaid, CHIP and other health care programs for the indigent and uninsured.

We seek restoration of Medicaid funding to pre-2003 levels and support efforts to address the current estimated budget shortfall of $109.5 million with minimal impact to care for the uninsured. We also support expanding eligibility for Medicaid and CHIP to levels allowed by federal law.

January 2007