“I still can’t get health insurance,” Rochelle told me last week. I was surprised she knew about her lack of coverage by the Affordable Care Act, but it was on the list of things I was going to discuss with her that morning. I had already researched it and she was correct. Texas is a state that has opted out of increasing the coverage for Medicaid to include healthy, non-pregnant, young and middle aged women. Men aren’t covered at all until they become old or disabled in Texas, and they weren’t going to fare any better with the new act, either. Texas wasn’t expanding Medicaid at all under the Affordable Care Act, mostly known now as Obamacare. I remember being stunned a year ago when Rochelle had first told me she didn’t qualify for Medicaid. I thought she was just misinformed. No, I was misinformed. Eventually I found something that allows her clinic care and a physical once a year. It is far removed from health insurance but far better than nothing.
Rochelle’s problem is that she is too poor, too healthy, and too young to be covered by the new law. Mostly she is too poor. It makes no sense at all, except if one lives in Texas, and 15 to 22 other states (depending on their final decisions), that is exactly the situation. If Rochelle were single and childless and making $10/hour she could sign up right away and be eligible for health care in January, 2014; but Rochelle is single, has three children, and makes $9.17/hour so she doesn’t qualify. The Affordable Care Act just assumed that states would increase their Medicaid coverage to include the people well below the federal government poverty line, if they were not already covered by it. The law didn’t prepare for states to reject the idea of increased Medicaid coverage. Texas has more uninsured people than any other state in the union, and it looks as if it will remain that way.
I explained to Rochelle why it was that she wasn’t going to be covered by the law. She had voted twice for Barack Obama and was somewhat taken aback when she discovered the health care law wasn’t going to make any difference to her life. There will be quite a lot of people who are better off and able to get health care because of the new law; Rochelle won’t be one of them because Rick Perry, the governor of Texas, seems to have no understanding of poverty nor the cost to the state and the tax payers when those not covered by Medicaid use the emergency room as their family doctor. I explained all this to Rochelle. “Well, I heard he isn’t running again,” she said hopefully. No, he isn’t, but it is doubtful his most likely replacement will think differently. And so, again, Rochelle falls through the cracks, and there is no safety net for her. I find it totally astonishing. Rick Perry should be ashamed of himself.