Texas has the largest uninsured population in the county and the Rio Grande Valley region is no exception. Health insurance coverage is important for well being as the uninsured are less likely to seek medical and preventive services. Uninsured residents of the Valley cross the border to Mexico for care and some delay or never receive care. The medical care coverage challenges of Rio Grande Valley are too complex and too vast for a single blog post; however, I will like to share with you one I found interesting.
The Affordable Care Act was expected to expand Medicaid to more low-income people in the United States. However, some states including Texas have decided to forgo the expansion. This has important public health implications for the Valley because of the large rate of poverty in the region.
What is the Medicaid Expansion? Under the Affordable Care Act, states can receive federal money to expand their Medicaid programs. Medicaid is a federally regulated but state run health care program for needy families. Under the Medicaid expansion, states could cover adults under 65 who make up to 133% of the federal poverty level.
Medicaid represents a large financial burden for most states. Under the ACA, the federal government will pay states all of the costs of newly eligible people for the first three years of enrollment. In the consecutive years, the federal government would pay no less than 90 percent of the costs of Medicaid enrollees.
When the ACA was signed in 2010, Medicaid expansion was mandatory for all states wanting to receive federal money. However the U.S Supreme Court later ruled that the Medicaid expansion had to be voluntary. Under this ruling, Texas chose to deny Medicaid expansion in the state.
Texas misses the opportunity to cover the poor in Rio Grande Valley Although Rio Grande Valley is an economically complex and culturally rich region of Texas, it also represents the poorest region of the state. The Valley is located in the most southern tip of Texas and borders with Mexico. Not surprisingly, more than 90% of the population is Hispanic. This ethnically diverse and economically disadvantaged community lacks adequate access to medical care and preventive services.
Texas has federally run exchanges, which means people in the Valley can still go to the exchange to buy health insurance under the ACA. However, for many people who struggle to make ends meet, adding another monthly bill is strenuous. Health insurance might not be the biggest priority when you are poor and have to worry about meeting your basic and immediate needs. Medicaid expansion could have benefited Texans everywhere; however, it would have a large impact in Rio Grande Valley where many are uninsured and live in poverty.
Understanding the ACA is an important step in helping medically underserved communities. Many see the ACA as a win for public health. However, we must consider the impact it has on the most disadvantaged communities. Having just studied the ACA in my Health Management and Policy course, it was fascinating to see how uniquely Rio Grande Valley region is experiencing the law.