Large Number of Uninsured Threatens Texas Health Care
The large number of uninsured residents in Texas -- an estimated 24% of the population, the highest in the nation -- has led to a health care "crisis," particularly in the Houston area, USA Today reports.
According to USA Today, the Houston area "offers a lesson for the nation" in that if the uninsured population gets "out of hand," the country "won't just have a less healthy population" but "an overwhelmed health care system."
Texas' large proportion of uninsured residents stems from several causes, including the large number of small businesses that do not provide health benefits for workers, low income-eligibility levels for Medicaid, reluctance from the state Legislature to invest in SCHIP and a growing population.
The large number of uninsured has pushed hospital emergency departments "to the breaking point," according to USA Today. Demand for EDs increased by 18% from 1994 to 2004 across the U.S., while demand in Texas increased by 33% and in Houston by 50% over the same period.
Meanwhile, lower reimbursement rates by insurers have caused hospitals nationwide and in Texas to close unprofitable units, such as EDs. The number of EDs in the U.S. decreased by 12% from 1994 to 2004.
However, the "greatest demand for health care" in Houston is not in EDs but in the "clinics and health centers designed to relieve them," according to USA Today.
USA Today reports that wait times to get an appointment at clinics and health centers can take months. The "huge number of uninsured residents" in the Houston area "means that health officials must make tough decisions every day about who gets treated and when," USA Today reports.
Texas has taken several steps to increase the number of insured residents (Wolf, USA Today, 6/19).
In late May, state lawmakers approved legislation that would ease some restrictions on SCHIP enrollment by allowing families to enroll once a year instead of twice, eliminating the 90-day waiting period for children not previously covered by an insurance plan and changing restrictions on a family's assets (California Healthline, 6/12).
In addition, Texas Gov. Rick Perry (R) last week signed a bill that could expand health coverage to as many as 200,000 low-income Texas residents (California Healthline, 6/18).
Still, "there is nothing being proposed on the scale of" Massachusetts' health insurance law, USA Today reports.
A statewide health proposal similar to Massachusetts' would cost $6 billion in Texas, according to Camille Miller, president of the Texas Health Institute.
Hospitals and state agencies have implemented programs to ease the strain on hospitals and clinics, including an outreach campaign to educate residents on when to visit an ED or a clinic; the development of less costly insurance products; the "Gateway to Care" program, which helps uninsured residents find primary or specialty care at clinics; and the "Ask Your Nurse" program, which offers phone advice to residents (USA Today, 6/19).