There was a lot of good news in the Census report released this week on health coverage in the U.S. in 2015. For example, the report told us that 90.9 percent of people in our country had health insurance coverage for all or part of last year.
The biggest percentage drops in uninsured people were in these states: California (down 8.6 percent), Nevada (down 8.4 percent), Kentucky (down 8.3 percent), West Virginia (down 8 percent) and New Mexico (down 7.7 percent). All of these states expanded their Medicaid programs (although Kentucky’s governor is now trying to make some controversial changes to its Medicaid program that Raising Women’s Voices opposes.) These states also established their own ACA health insurance marketplaces (although Nevada and New Mexico are using the federal healthcare.gov website for enrollment and West Virginia ultimately chose a state/federal partnership model).
But where are there still the most numbers of uninsured people? A Census table showed the percentage of uninsured people in each state, from 2013 to 2015. Guess which state was No. 1 for uninsured people? We bet you won’t be surprised to learn it was Texas, a state that has refused to expand its Medicaid program and defaulted to a federally-facilitated marketplace when state officials refused to create their own. The estimated number of uninsured people in Texas in 2015 was a whopping 4,615,000.
Our RWV regional coordinators in Texas – the Lesbian Health Initiative in Houston and The Afiya Center in Dallas – have been working hard to improve their state’s coverage numbers by advocating for Medicaid expansion and helping to reach and enroll uninsured people who qualify for the available coverage options in Texas.
Other states with the largest number of uninsured people are California, No. 2 with 3,317,000 still uninsured; Florida, No. 3 with 2,662,000 uninsured people; Georgia, No. 4 with 1,388,000; and New York with 1,381,000 still uninsured. The listings for Florida and Georgia are not surprising because both states have politicians who have been refusing to cooperate with ACA implementation, including expanding Medicaid. In recent months, there have been some signs of possible movement in Georgia in 2017.
But what about California and New York – two progressive states with their own ACA marketplaces, Medicaid expansion and records of dramatically reducing uninsured rates? One of the key factors in both states is their large populations of immigrants who do not qualify for any of the various ACA coverage options. What can be done about this problem, which stems from the ACA’s restrictions on coverage for immigrants?
California is asking the federal government to approve a plan that would allow undocumented immigrants to buy health insurance on California’s ACA marketplace. State officials estimate that up to 30 percent of California’s two million undocumented immigrants could be eligible for this program. No federal dollars would be used for this expanded coverage. The state already took a first step toward covering more immigrants this year with a new law that allows undocumented children to sign up for Medi-Cal, California’s Medicaid program. California Latinas for Reproductive Health (CLRJ) has been active in educating policymakers about the need for these coverage expansions, and Raising Women’s Voices submitted comments supporting the state’s request to the federal government.
In New York, some immigrants have already been covered through the new Essential Plan, which is that state’s version of the Basic Health Program option allowed under the ACA. But an estimated 450,000 New Yorkers remain uninsured because of their immigration status. The Health Care for All New York coalition – in which Raising Women’s Voices-NY serves as a steering committee member – is advocating for additional expansions of coverage to groups of immigrants through participation in a Coverage4 All campaign led by the New York Immigration Coalition and Make the Road New York.