Full Citation
Title: Estimates of the Impact of the Affordable Care Act on Texas Counties
Citation Type: Miscellaneous
Publication Year: 2012
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Abstract: As of 2010, an estimated 23.7 percent of all Texans (5.9 million people) had no health insurance coverage, a larger percentage of population uninsured than any other state. The Affordable Care Act (ACA), the most comprehensive health care program passed by the Congress of the United States since 1965, is designed to expand health insurance coverage so that more people have access to health care. Despite its comprehensive nature there are likely to be persons who will not be covered by insurance even after full implementation of the ACA, either because they are exempt from specific provisions of the Act or because, for various reasons, they choose not to obtain health insurance. The differences in how many enroll in some form of health insurance will depend upon the efforts of the State of Texas and health care advocates to enroll people in public health insurance (Medicaid and CHIP) and how well the health benefits exchange is developed and marketed. Given the population in Texas in 2010, and had all of the provisions of the Act been implemented in 2010 and assuming a moderate scenario that increases enrollment in public and private health insurance, we estimate the following changes: A 3.0 million decline in the uninsured from 5.9 million to an estimated 2.9 million; 88% of Texans (and 87% of non-elderly Texans) would be enrolled in some form of health insurance (up from 77% and 74%, respectively); 165 counties would have larger percentage increases in the number of insured than the State as a whole (at a 15.3% increase); 34 counties would have larger proportions of the population remaining uninsured than the State as whole (at 11.6%) including: o The largest urban counties, including: Cameron (13.7%), Dallas (14.1%), El Paso (12.9%), Harris (13.9%), Hidalgo (15.0%), Tarrant (12.0%), and Webb (14.2%); o Many rural counties throughout Texas; o Counties in the South and West Texas border area. The percent and number uninsured decreases for all counties. Areas in Texas that will benefit most from the ACA are those counties where health insurance rates are already low. These counties are located primarily in rural areas of the state and in particular, areas in South and West Texas, and central city counties. After full implantation of the ACA, we estimate the following changes by county type: Average percent uninsured will decrease from 22.7% to 10.0% for rural counties, increasing the number of insured rural Texans by 395,000 people (16.8% increase) Average percent uninsured will decrease from 23.7% to 11.0% for central city counties, increasing the number of insured urban Texans by 2.0 million (15.8% increase); Average percent uninsured will decrease from 21.1% to 9.5% for suburban counties, increasing the number of insured suburban Texans by 587,000 (13.3% increase) These geographic differences in impacts are a result of differences in the socioeconomic and demographic characteristics of county populations and how the provisions of the Act will differentially impact specific demographic groups. Counties most impacted by the provisions of ii the Act will be those with larger proportions of their population in households with low to moderate income because these are the households who benefit most from two major provisions of the Act: (1) an expansion of Medicaid coverage to persons in households with incomes less than or equal to 138 percent of the Federal Poverty Level (FPL) and, (2) the development of a Healthcare Insurance Exchange with subsidized coverage for those persons in households with incomes less than or equal to 400 percent of FPL. Those counties with higher relative proportions of their population uninsured following full implementation of the ACA are those counties with larger numbers of immigrants, fewer governmental employees, and larger proportions of the population with low to moderate incomes. This report provides an overview of the estimated impacts of the ACA as passed and fully implemented and the methods used to estimate these impacts.
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Authors: Cline, Michael E; Murdock, Steve H
Publisher: Methodist Healthcare Ministries
Data Collections: IPUMS CPS
Topics: Health
Countries: United States