Lack Of Insurance No Barrier To Health Care In Texas

NCPA Suggests Free Care Funds Be Spent for Private Health Insurance

DALLAS (August 31, 2000) - The major reason nearly one in four Texans lacks health insurance is an extensive system of free health care that makes private health insurance unattractive for many Texas families. The findings are contained in a new report from the National Center for Policy Analysis (NCPASM).

"Why pay for private health insurance when free care is available right down the street?" said NCPA president John C. Goodman. "In Texas, the uninsured are uninsured in name only." Goodman said money that now funds free care for the uninsured could be used instead to assist families to obtain private insurance.

Texas spends an average of $1,000 on free health care for each uninsured individual every year. That equals $4,000 for a family of four-enough to buy adequate private insurance in most Texas cities. In addition, according to the NCPA report, more than 40 federal and many other state and local programs, as well as private charities, fund health services for uninsured Texans. For example:

  • The Disproportionate Share Hospital (DSH) payment program provides $1.5 billion in federal and state funds to Texas hospitals that serve a large numbers of indigent patients.
  • Texas law requires counties to serve the medically indigent; typically, hospital districts with taxing authority are formed to meet this requirement.
  • Texas law also requires non-profit hospitals to provide indigent care equal to 5 percent of hospital revenue.
  • Physicians provide nearly $1 billion in free services annually.

The system of free care in Texas discourages people from enrolling in publicly funded health insurance, Goodman added, citing official estimates that 1.6 million Texans may be eligible for Medicaid, but not enrolled.

"In most cities, Medicaid patients and the uninsured enter the same emergency rooms, see the same doctors, and receive the same medical care," Goodman said. "Medicaid enrollees do not get more, faster or better care. That's why the benefits of enrolling in Medicaid are not worth the bureaucratic hassles for many families."

Compounding the problem, Texas also has greater numbers of people who are harder to insure-young adults, single people and immigrants. "Many young, single and healthy Texans have decided to spend their money to meet non-health care needs, knowing they can get free care if and when they need it," Goodman said.