NCPA - National Center for Policy Analysis

Multitude Of Health Options In Texas Discourages Insurance Coverage

September 12, 2000

About one in every four Texans lack health insurance. But that doesn't mean they are going without medical care. In fact, there are more than 40 federal programs that fund health services for the uninsured in the state. Also, Texas law requires counties to have programs to serve the medically indigent.

So with all these subsidies and free services available, a substantial proportion of Texans -- 4.8 million out of 19.6 million, according to the U.S. Census Bureau -- don't bother to purchase or pay for health insurance. Experts say the federal government probably bears the bulk of the blame.

  • The largest single program -- spending more than $1.5 billion a year -- is the "disproportionate share hospital" payment program, designed to compensate hospitals that serve an above-average number of indigent patients.
  • There are also health-care grants for residents of public housing, seasonal farm workers, legal immigrants and even undocumented immigrants.
  • Texas requires nonprofit hospitals to provide indigent care equal to 5 percent of their revenue -- and state and local governments, charities and nonprofit providers run numerous other health-care programs.
  • Public and private organizations spend approximately $1, 000 per uninsured individual a year on charity care outside the Medicaid program

All this aid means that Texans without health insurance receive almost two-thirds as much care as is spent on Medicaid recipients.

Presidential candidate Al Gore's campaign is currently running a television ad suggesting that the health-care situation in Texas is worse than in other states -- and that Gov. George W. Bush is to blame. But the facts and the record argue against that politically-inspired conclusion, analysts point out.

Source: John C. Goodman (National Center for Policy Analysis), "What Mr. Gore Won't Tell You About Texas Health Care," Wall Street Journal, September 12, 2000.


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