High Health Plan Costs Serve as Healthcare Coverage Barrier in TX

Texan adults are more likely to be uninsured and forgo care due to cost barriers than the average American, according to a new survey from HealthCareInsider that raises concern for healthcare affordability. 

The survey revealed that 21 percent of Texans are uninsured, compared to 13 percent of respondents to a separate October 2020 national survey.

Additionally, 58 percent of Texans who lack health insurance say it is because they cannot afford it, compared to 53 percent of national respondents.

Texans also participate in public health insurance programs at much lower rates than the rest of Americans. The survey revealed that 20 percent of Texans are enrolled in Medicare, compared to the national rate of 25 percent. Similarly, just 7 percent of Texans are Medicaid beneficiaries, compared to 12 percent of national respondents.

Texas is one of 12 states that have not adopted Medicaid expansion, and this is not likely to change any time soon, according to Timothy Callaghan, PhD, assistant professor in the health policy and management department at Texas A&M School of Public Health.

“Pundits have long hypothesized that Texas will turn purple, but you’d have to have a blue legislature and receptive governor for a Medicaid expansion,” Timothy Callaghan, PhD, an assistant professor in the Department of Health Policy and Management at the Texas A&M School of Public Health, said in a press release.

“I don’t see that happening given the many state representatives who oppose the Affordable Care Act,” Callaghan continued. “Many legislators still see the ACA as something associated with Obama and many conservative Texans wouldn’t be happy with that.”

According to the survey, Texan adults were 6 percent more likely to opt out of healthcare services between February and October of 2020 than the rest of American adults (52 percent vs. 46 percent, respectively).

Almost 30 percent of Texans skipped dental services (29 percent) and 24 percent opted out of vision care services. Additionally, 19 percent of Texans did not receive preventive care and 11 percent did not seek ED care.

According to the survey, 39 percent of Texans skipped care because they could not afford it—seven percent more than the 32 percent of national respondents who opted out of services due to cost-related barriers.

The survey found that medical bills were the number one healthcare expense for 18 percent of Texans, compared to 15 percent of all Americans.

Prescription drug costs are also driving Texans healthcare affordability struggles, with 11 percent of Texans ranking prescription drugs as their number one healthcare expense. Nationwide, 8 percent of Americans ranked prescription drugs as their most costly healthcare-related expense.

According to the survey, costly healthcare services are leading many Texans into debt. While 28 percent of adults nationwide say they carry medical debt, 36 percent of Texan adults report debt related to medical expenses.

What’s more, 32 percent of Texans reported that they had received a surprise medical bill in the past year, compared to 28 percent of national respondents said the same.

“The reality is when you have a large uninsured population, you’re going to see people avoid seeking healthcare due to cost,” Callaghan explained. “For the most part they seek out emergency room care, or some sort of clinic that accepts individuals without health insurance, which often results in very large out of pocket costs. The process becomes infinitely harder to navigate if you don’t have health insurance.”