Roughly 1 million Texans are unable to qualify for Medicaid under Texas' stringent restrictions and unable to afford to purchase plans offered under the Affordable Care Act.

Working poor Texans struggle in Medicaid, ACA gap

by MARK WIGGINS / KVUE News and photojournalist PETER HULL

Bio | Email | Follow: @MarkW_KVUE

kvue.com

Posted on February 5, 2014 at 6:29 PM

Updated today at 6:41 PM

AUSTIN -- For 28-year old Irma Aguilar, raising four young children while working a full-time job is difficult enough.

Suffering from a damaged disc in her neck and debilitating high blood pressure that leaves her dizzy and bouts of anxiety, she needs medical coverage. An assistant manager at a national pizza chain, the San Antonio resident earns too much to qualify for Medicaid, but too little to qualify for discounted plans on the health insurance marketplace.

"It just makes me feel like, how am I supposed to get help? I thought that working hard for your money was supposed to help you go on in life and help you get some kind of insurance, and we can't even get that," said Aguilar. "We're the ones working hard. We're the ones doing everything, and we can't even get a penny out of it. We don't get nothing. So, do I have to stop working and let my kids drain and me drain so that way I can get help? It's just not fair to me, and it's not fair to my kids."

Roughly 1 million Texans are in a similar situation: unable to qualify for Medicaid under Texas' stringent restrictions and unable to afford to purchase plans offered under the Affordable Care Act. On Wednesday, representatives of dozens of organizations gathered at the Texas Capitol to launch a new campaign demanding something be done for them.

"It's a moral responsibility to address this situation," said Sister J.T. Dwyer of the Seton Health Care Family. "Our mission is to care for and improve the health of those we serve with a special concern for the poor and vulnerable. So, wouldn't we be interested in this? These are the vulnerable people who are left out."

With 6 million uninsured individuals, Texas leads the nation in the number of residents without health care coverage. A project of the Cover Texas Now Coalition, Texas Left Me Out is a campaign to compel lawmakers to develop a solution to insuring Texas' working poor who fall in the coverage "gap" resulting from the U.S. Supreme Court's decision not to require states to expand Medicaid to those unable to afford coverage through the health insurance marketplace. 

"The problem is that, because the law was written assuming that the Medicaid piece would be there, they said nobody below the poverty line is going to get the sliding scale of subsidies with premiums in the new health insurance marketplace," said Anne Dunkelberg, associate director of the progressive Center for Public Policy Priorities.

For a $15 billion investment in state money, over the next 10 years Texas would draw down about $100 million in federal funds, which Texans will be taxed for regardless. Gov. Rick Perry has opposed expanding Medicaid, calling the system "broken." Instead, Perry has advocated for a block grant which the federal government has thus far seemed disinclined to provide.

Read More and Watch Video Here

Related articles

• Working poor Texans struggle in Medicaid, ACA gap
• Activists launch ACA 'coverage gap' initiative
• Study puts new Medicaid enrollment under Obamacare at fewer than 2 million
• Enrollment issues leaving Texas children uninsured
• Living Poor and Uninsured in a Red State - Olga Khazan - The Atlantic