The Local Problem

In a number of my posts on healthcare reform I suggested that, rather than actually being a national problem, the problem of the uninsured was a local problem with national ramifications. In the wake of the passage of the healthcare reform bill that theme is being repeated loud and clear. Here’s a fine instance:

Texas, which has some of the most restrictive Medicaid eligibility rules in the country for adults, currently covers working parents only if they do not earn more than roughly 20 percent of the federal poverty level. The program does not cover childless adults.

Anne Dunkelberg, associate director of the Center for Public Policy Priorities, a research group in Austin that strongly supported the health care law, estimated that if the legislation went into effect today, an additional one million adults would qualify for Medicaid, at a cost of $370 million a year if Texas were to pay its full 10 percent share.

In addition, Ms. Dunkelberg said, many children who are currently eligible but are not enrolled in Medicaid and the state Children’s Health Insurance Program will emerge and want to join, potentially costing the state several hundred million dollars.

The uninsured are disproportionately in just a handful of states. The broad brush of the healthcare reform bill will paint Texas and the other states who have most of the uninsured as well as those who have significantly smaller numbers and proportion.