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Exchange type: Federally facilitated
Medicaid expansion: No
Enrollment update: As of March 1, 2104, federal data showed that 295,025 Texans had selected health insurance via the Health Insurance Marketplace—they may or may not have made their first premium payment.1 Texas is among the 27 states that opted to let the Department of Health and Human Services operate its health insurance exchange.
Furthermore, recent enrollment data shows the following2:
In terms of the sheer number of individuals who have selected a Marketplace plan, Texas ranks third.3 California and Florida are first and second, respectively. However, along with California, Florida and New York, Texas is among the four most populous states.
When it comes to percent of eligible persons enrolled, Texas is far from the top. It is estimated that more than 3 million Texans could enroll for health insurance through the Marketplace.4 As such, the 295,025 who have enrolled represent less than 10 percent potential Marketplace enrollees. Based on the percent of the potential population enrolled in state-based and federally facilitated exchanges, Texas ranks 38th—just below Ohio and just above Louisiana.
Texas has the highest rate of uninsured in the United States, a number 1.5 to 2 times the national average, according to the Texas Medical Association.5 More than 6.3 million in the state lack health insurance, this number includes adults and children.
In related news: A Kaiser Health News article recently listed Texas as one of 10 states critical to hitting the 6 million enrollee mark projected by the Obama administration.6 The article noted, “As in most Southern states, officials have been openly hostile to the law.” Politically motivated resistance as well as a lack of certified helpers to assist people in shopping the Marketplace may be among the reasons for low enrollment. According The Washington Post’s blog The Fix, the state in January passed laws that made it difficult to become a navigator and that “only 39 percent of Texas residents have a favorable opinion of Obamacare.”7
Furthermore, 32 percent of Texas’ population is Hispanic, according to the State of Texas.8 Troubles with CuidadoDeSalud.gov, HealthCare.gov’s Spanish website, and rumors that legal immigrants who enroll for health insurance via HealthCare.gov may put their illegally present relatives at risk for deportation may also be discouraging some applicants. Improvements to the website have been reportedly made, and President Obama publically assured immigrants that signing up for health insurance would not put their families at risk.9
1 U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. (2014, March 11). "Health Insurance Marketplace: March Enrollment Report: For the Period: Oct. 1, 2013–March 1, 2014."
3 The Henry J. Kaiser Family Foundation. (2014, March 11). "State Marketplace Statistics."
4 The Henry J. Kaiser Family Foundation. (2014, March 11). "Marketplace Enrollment as a Share of Potential Marketplace Population."
5 Texas Medical Association. (n.d). "The Uninsured in Texas."
6 Galewitz, Phil. (2014, March 19). "10 States are Critical to Administration’s Efforts to Enroll 6 Million in New Health Plans." Kaiser Health News.
7 Fuller, Jaimie. (2014, March 21). "Seven States that Show Just How Hard it is to Measure Obamacare’s Success [Blog]." The Washington Post.
8 Combs, Susan, Texas Comptroller of Public Accounts. (n.d.). "Demographics—Texas in Focus."
9 Easley, Jonathan. (2014, March 18). "Obama to Hispanics: We Won’t Deport Relatives Because You Enroll in ObamaCare [Blog]." The Hill.
Jenifer Dorsey is a freelance writer whose specialties include health and fitness, wellness, sports and recreation. She is a competitive amateur track cyclist who also enjoys mountain biking, hiking, camping and other outdoor adventure. Jenifer received a B.A. in journalism from Columbia College Chicago and is an MFA candidate at Naropa University. She lives in Colorado.