Texas has the highest percentage of uninsured women between the ages of 18 to 44, according to a new study from the Georgetown University Center for Children and Families.
The study found that, nationwide, 12.3 percent of women of childbearing age don't have health insurance. The rate in Texas, however, is more than double the national average – at 25.5 percent.
Joan Alker, the center’s executive director, said, overall, the study found rates in states that have not expanded Medicaid were roughly double the rate of uninsured women, compared to those that have expanded Medicaid.
Texas is among a minority of states that has decided not to expand its Medicaid program to more low-income adults through the Affordable Care Act. According to the Kaiser Family Foundation, to date, 37 states – including DC – have expanded their programs.
Alker said Texas’ refusal to expand health coverage is among a variety of reasons the state’s rate is the highest in the nation.
"That reflects the state's policy choices," she said. "Low-wage workers don’t have offers of affordable health insurance in a state like Texas, perhaps more so than other states."
Texas' large Latino population is also affecting the state’s rate. Latinos, overall, have been less likely to be insured compared to white, black and Asian populations.
The state also has strict income limits to qualify for Medicaid, Alker said, which is also driving down insured rates among women.
"You have to be so poor in Texas that you have to have under $300 a month to be eligible as a parent for the Medicaid program," she said. "That is one of the lowest eligibility levels in the country."
Republican leaders in Texas have refused to expand its Medicaid program since the Affordable Care Act was enacted in 2010, and the state’s overall uninsured rate has been the highest in the country for many years.
"It is a shame that politics continues to win the day over the health of women and children," said Laura Guerra-Cardus, the deputy director for the Children’s Defense Fund.
Even though expansion under the Affordable Care Act was seemingly off the table during this year’s ongoing legislative session, Guerra-Cardus said there were efforts to expand coverage for women and babies, specifically. Those efforts have been unsuccessful, so far.
For example, the Texas Senate has yet to consider House Bill 744, which would allow low-income mothers to maintain their Medicaid insurance coverage for 12 months after giving birth. Currently, women are removed from the program two months after delivery. The bill was part of an ongoing effort to address the state’s maternal mortality crisis.
"We just need to do a better job at this," Guerra-Cardus said. "And unfortunately, this session – as it wraps up – is showing us that health care coverage again is not a priority for Texas leaders the way it should have been."
Alker said there’s evidence expanding Medicaid tends to lead to healthier pregnancies.
"Research is starting to come out showing that Medicaid expansion has played a key role in reducing rates of maternal death, decreasing infant mortality and improving the potential for optimal birth outcomes," she said.