November 23, 2023

Rice University’s Baker Institute for Public Policy reports that more Texans have health insurance coverage now thanks to the Affordable Care Act. According to the Institute’s November 14 issue brief, entitled Looking at the Numbers: 10 Years of Data on the Affordable Care Act Reveal Benefits for Texans:

“When the ACA was enacted in 2010, Texas had the highest uninsured rate (23.7%) in the country — 5.6 million people. The Texas Health and Human Services Commission estimated that full implementation of the ACA could cut the uninsured rate in half, with 36% or 2 million people gaining subsidized coverage through the ACA marketplace and 24% or 1.3 million people gaining coverage through Medicaid expansion.

“However, Texas did not embrace the ACA as a pathway to provide coverage for its citizens. In fact, the state fought the law at every turn in the early years, filing numerous lawsuits challenging its legality, refusing to support access to ACA marketplace plans through available channels, and declining to expand Medicaid.

“Notwithstanding these obstacles, the ACA has benefited Texans, particularly the marketplace, which has enabled over 2 million people to obtain affordable coverage not otherwise available in the state. Our review of 10 years of data shows how the ACA marketplace helped reduce the rate of uninsured Texans by one-quarter, from 23.7% in 2010 to 18% in 2021.”

Among its recommendations, the Institute suggests that Texans could benefit greatly from the creation of a state-based health insurance marketplace exchange:

“The noticeable increase in ACA enrollment in Texas has prompted state lawmakers to consider the creation of a state-based marketplace exchange in Texas. This reflects a marked shift among lawmakers in recognizing the ACA as a credible and effective policy tool to address health coverage needs for lower-income Texans. While the merits of this proposal have yet to be fully debated, this marks a change in attitude by lawmakers about the ability of the ACA to solve Texas’ persistently high uninsured rates. Texas continues to experience the highest uninsured rate in the country, and the coverage problem is compounded by the recent removal of 1 million enrollees from Medicaid as the pandemic winds down. The ACA has a lot to offer Texans, and we urge the Legislature to find ways to maximize its impact.”

World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems and policies in the US and sixteen other nations.

Page last updated November 23, 2023 by Doug McVay, Editor.