By Juan Flores
(Editor's Note: Though the following post speaks about Texas, it's important to note that in those states that are also considering refusing the Affordable Care Act (ACA), and Latinos comprise a percentage of their population, the scenario in Texas could easily be replicated in those states as well.)
The Affordable Care Act (ACA) is important to the health and economic future of Texas. The Governor and legislative leaders who take a ‘no’ position on implementing the ACA in Texas lack compassion, ignore objective facts, and perpetuate injustice.
Compassion: Texas already has one of the most stringent Medicaid programs in the country, yet in 2010, the 82nd Legislative Session leaders further cut and underfunded Medicaid. This was accomplished while also failing to use the States’ Rainy Day Fund to minimize the health and financial damage to the most vulnerable; children, seniors and the disabled. These shortsighted decisions heighten our national decade-old standing as the state with the most uninsured and underinsured population in the country.
Failure to implement the Medicaid expansion and Health Care Exchange will mean millions of uninsured Texans, particularly a disproportionate number of Latinos, will continue to be at-risk for poor health and financial consequences. With ACA, an estimated one million additional adult Texans with poverty-level incomes will be insured. Furthermore, the Health Insurance Exchange will help an estimated 2.5 million uninsured low to middle-income Texans to purchase affordable health insurance coverage.
Ignoring the Facts: Texans have one of the lowest rates (51%) of employer-base health insurance coverage in the country. Among Latinos it’s only 39%.
Our state has some of the highest healthcare costs in the country, yet overall healthcare quality ranks 50th in the nation.
Houston, with its world-renowned medical centers has twice the national average of its residents with poor or fair health. The ACA eliminates pre-existing conditions as a barrier to health insurance coverage, expands preventive care for women and seniors, low and middle-income seniors with increased access to affordable drugs, and allows parents to enroll and keep their children’s health insurance coverage through age 26. It also provides expanded access to comprehensive primary health care to the uninsured and under-insured through community health centers.
Access to affordable health care is essential because without it, opportunities to learn, work, earn a living wage and create wealth, and be a productive citizen are all diminished.
Injustice: To block the ACA is an injustice. The ACA will create an equal opportunity for access to quality healthcare. The disparities, inequalities, and the costly way our healthcare system functions are extensively documented. Second, health prevention is a priority that reduces poor health risks and maintains good health. Third, improving cost-effective quality care in the management of chronic health conditions is a major priority.
Among Latinos, national polls demonstrate their strong support for the ACA. Our values are aligned with the historic decision to reform healthcare. In Texas, we represent 37% of the population yet 58% of the uninsured. Research indicates that the shift to a Latino majority state also means a shift to greater incidence and prevalence of chronic disease. Not seeking preventive care, prevalence of chronic health conditions, excessive emergency room use, lost work productivity and related financial insecurity are disparities and inequities that can be addressed through the ACA.
As we approach the November elections, healthcare and Medicare dominate the political and policy discussions and some question the effectiveness of ACA. Yet, the VA health system and Medicare are forms of socialized medicine with high marks for providing quality healthcare.
Those who say “we must control healthcare costs” are short-sighted and ignore the victims and the powerless. Too many Texas political leaders are rich in biased ideology and political rhetoric which has little to do with reasonably objective conservative or liberal values on policy positions.
As a result, Texas is near dirt-poor in human investments in education and health. The politics and policies that favor the few are a central message why it’s okay to be a low-pay and poor income state – most of us may have a job, but many just get by day to day. For the average Texan, it creates a high-risk environment for poor health and financial insecurity.
Good health is a financial asset because it contributes significantly to individual and family financial security, and our state’s economic growth. For the hard-working uninsured Texan, gaining insurance coverage becomes a gateway for basic access to quality healthcare, to increased opportunity to achieve financial security, and to progressive improvements to their family's bienestar (well-being).
The Supreme Court decision reinforces that the ACA is the law of the land – let’s make it the law in Texas when the 83rd Legislative Session begins in January 2013. Demand support for the ACA’s expansion of Medicaid and the Health Insurance Exchange from your legislative representative.
Juan Flores is executive director of La Fe Policy Research and Education Center