Why More Uninsured Texans Boosts Biden Over Trump

The rising number of uninsured Texans is expected to figure prominently in this year’s Presidential election where Democrat Joe Biden is pushing to expand coverage and Donald Trump continues to talk about dismantling Obamacare.

A snapshot of the importance of healthcare in Texas can be seen in a report out last week showing the state’s already first-in-the-nation rate of Americans without health insurance is going to get even worse. More than 1.2 million Texans have lost coverage amid record unemployment applications in an economy struggling with the Coronavirus strain COVID-19.

An Episcopal Health Foundation analysis of Texas job losses and health insurance eligibility shows that more than 1.1 million residents of the state “could be part of the uninsured who become stuck in the state’s health insurance ‘coverage gap.’” This comes as Texas already has more uninsured than any other state and the highest percentage of people in a coverage cap compared to other states, the analysis shows.

Meanwhile, polls show a tight race in Texas between Biden and Trump with the Democrat narrowly ahead. Polls on healthcare issues such as Medicaid expansion, which Trump opposes, have shown two-thirds of Texans support Medicaid expansion, an Episcopal Health Foundation survey shows.  

Texas is among 14 U.S. states that hasn’t expanded Medicaid under the Affordable Care Act so those losing their jobs will have fewer options to find coverage compared to most other U.S. states. “Expanding Medicaid and increasing state efforts to enroll recently jobless Texans in ACA health plans could prevent approaching crisis,” Episcopal Health Foundation reported.

Biden favors expanding Medicaid under the ACA, which was signed into law by President Barack Obama 10 years ago when Biden was vice president. Biden favors improving the ACA as well as expanding healthcare coverage to more Americans such as his recently announced proposal to allow Americans between the ages of 60 and 64 the option of buying into Medicare, the federal health insurance program for the elderly. 

Trump, however, has been working to uproot the ACA as well as its subsidized individual coverage known as Obamacare and also opposes expanded Medicaid. And the Justice Department under Trump appointees have been working with Republican attorneys general to repeal the ACA.

“Health care has been the top priority in the last two elections, and that certainly isn’t going to change during a pandemic,” said Jonathan Schleifer, executive director of The Fairness Project, which has been working with several states to expand Medicaid via ballot initiative. “The issue is going to drive election results across the country, including in the presidential race. In a state like Texas, which continues to abandon more than a million workers without access to health care, it will be a huge factor.” 

In Texas, policymakers need to look at new ways to expand coverage to avoid a “looming health insurance crisis,” authors of the Episcopal Health Foundation report said. They estimate 27% of all Americans “stuck in the coverage gap will live in Texas” in 2021.

“These estimates are only related to job losses through the beginning of May, so the crisis could be much worse,” Episcopal Health Foundation’s president and chief executive Elena Marks, who was co-author of the analysis said in a statement accompanying the report.

The foundation report didn’t address the presidential race or proposals by Biden or Trump. It did, however, direct comments toward policymakers in Texas who would need to approve of Medicaid expansion.

“Policymakers need to consider Medicaid expansion or another option to extend health insurance coverage so that more at-risk Texans have access to affordable health care during this crisis,” Marks said. “If they don’t, uninsured Texans won’t be the only ones who suffer. The costs will be passed on to doctors, hospitals, and state and local governments.”