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DEMOGRAPHY
While 81% of all Texans have health insurance, over 6.5 million individuals remain uninsured,3 including
11% of Arizona’s children 4 and 28% of the state’s working population.5
ACA is designed to address these concerns by providing affordable access to health insurance coverage
to those individuals who would otherwise be unable to obtain coverage, and to extend current benefits
and services provided by Medicaid (a federal and state funded public insurance program that provides
health insurance coverage for low-income and disabled individuals and families).
ACA establishes new requirements for private health insurers in order to make health
Insurance care plans more accessible to the public. These requirements include the following:
Coverage Effective Immediately: Plans must cover certain preventive health services, such as
vaccines and screenings, without a co-pay.
Successful implementation of ACA will require a joint effort among local, state, and federal agencies, as
well as many non-governmental organizations. The State of Texas will face several challenges:
Budget 12 – The limited budget in Texas will be a real challenge for implementation, specifically
when expansions for services are expected. In May 2010, the Texas Health and Human Services
Commission reduced its budget by 23%. This reduction severally affects Medicaid and other health
care delivery services in Texas.
Health Care Workforce – With the potential increase of Texas's insured population, it is important
that primary care physicians and other necessary health care professionals are engaged in health
care reform. ACA provides grants and loan forgiveness to health care professionals; this will help
Texas ensure that it has an appropriate supply of doctors, nurses, social workers, and other
professionals to cover the increased demand.
Diverse Population – Texas's diverse population presents a special challenge to those implementing
ACA in the state. A key concern for Texas residents regarding their current health care system is
access to care. Providers must be sensitive to the state’s language, economic, and cultural diversity.
This means that access to care and the ability to understand one’s treatment should not be
threatened by one’s ethnicity, language, culture, or economic status.
1
U.S. CENSUS BUREAU. STATE AND COUNTY QUICKFACTS (2010), available at http://quickfacts.census.gov/qfd/states/48000.html (last accessed
June 2010). These figures are from 2009.
2
Ibid. These figures are from 2008.
3
THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured
estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual Social and Economic
Supplements), available at http://www.statehealthfacts.org:/comparetable.jsp?ind=125&cat=3 (last accessed June 2010).
4
THE KAISER FAMILY FOUNDATION, statehealthfacts.org. Data Source: Urban Institute and Kaiser Commission on Medicaid and the Uninsured
estimates based on the Census Bureau's March 2008 and 2009 Current Population Survey (CPS: Annual Social and Economic
Supplements), available at http://www.statehealthfacts.org:/comparetable.jsp?ind=127&cat=3 (last accessed June 2010).
5
COVER THE UNINSURED, ROBERT WOOD JOHNSON FOUNDATION, U.S. UNINSURED WORKERS, available at
http://covertheuninsured.org/uninsured_workers#map (last accessed June 2010). These figures are from 2006-2007.
6
Small businesses include employers with fewer than 50 employees.
7
U.S. DEP’T OF HEALTH & HUMAN SVCS. MEDICAL EXPENDITURE PANEL SURVEY (2008), available at
http://www.meps.ahrq.gov/mepsweb/data_stats/summ_tables/insr/state/series_2/2008/tiia1.pdf. These figures are from 2008.
8
The federal poverty level for the 48 contiguous states is $10,830 for a single individual. ASSISTANT SEC'Y FOR PLANNING AND EVALUATION, U.S.
DEP’T OF HEALTH & HUMAN SVCS. THE 2009 HHS POVERTY GUIDELINES (2010), available at http://aspe.hhs.gov/poverty/09poverty.shtml (last
accessed June 2010).
9
National Conference of State Legislatures, Coverage of High-Risk Uninsurables: State and Federal High-Risk Pools (May 27, 2010) available at
http://www.ncsl.org/?tabid=14329#2010_Pools (last accessed June 2010).
10
Ibid.
11
JOHN HOLAHAN & IRENE HEADEN, KAISER COMMISSION ON MEDICAID AND THE UNINSURED, MEDICAID COVERAGE AND SPENDING IN HEALTH REFORM: NATIONAL
AND STATE‐BY‐STATE RESULTS FOR ADULTS AT OR BELOW 133% FPL 41 (2010), available at http://www.kff.org/healthreform/upload/Medicaid-
Coverage-and-Spending-in-Health-Reform-National-and-State-By-State-Results-for-Adults-at-or-Below-133-FPL.pdf (last accessed June
2010).
12
TEXAS HEALTH AND HUMAN SERVICES COMMISSION, Summary FY2010-11 HHS General Revenue Reduction Options, (May 18, 2010), available at
http://www.hhsc.state.tx.us/about_hhsc/2011-budget/reduction-options.shtml#approved (last accessed June 2010).