By Jeneen Interlandi
Texas has the highest uninsured population in the country, according to a Gallup poll released earlier today. More than one fourth of Texans—26.9 percent—ages 18 and older were completely uninsured.
It’s not the first time Texas has topped such a list. It’s not even the first time this week; similar data were reported by the U.S. Census Bureau yesterday and Texas ranked No. 1 on that list as well.
Texas Republicans, who have staunchly opposed the health-care reform efforts now underway, have been quick to pin the state’s abysmal insurance record on the high number of undocumented immigrants living within its borders. John Goodman, president of the National Center for Policy Analysis, a Dallas-based think tank suggested in a blog post that the numbers were artificially inflated. Because “even illegal aliens” are guaranteed care at emergency rooms, he wrote, everyone is effectively insured. In a press conference Friday, Sen. Kay Hutchinson (R-Texas) made a more explicit statement, saying, “It’s mostly because of the illegal-immigrant population.”
What they mean is this: illegal immigrants should not be counted among the uninsured because we aren’t obligated to provide them with health insurance in the first place. And when you remove the undocumented from the rolls, the picture is less bleak than the Gallup or Census numbers suggest.
It’s an obvious argument and because immigration is an emotionally fraught topic, it’s an easy one to make. Unfortunately, it’s not supported by the facts. (Even a casual glance at the data is enough to render the point moot: New York has one of the largest immigrant populations in the country, but only 11.9 percent of its residents are uninsured according to the Gallup poll; that’s one of the lowest uninsured populations in the country).
In fact, numerous studies, including ones by the Texas Department of Insurance, indicate that roughly 80 percent of those the Gallup organization or the Census Bureau would count as uninsured are actually U.S. citizens. “If we took all the immigrants out of Texas—legal and illegal—we would still have the highest uninsured rate in the country,” says Eva DeLuna, a budget analyst at the Center for Public Policy Priorities (CPPP), an Austin-based think tank.
A better explanation for the Texas data might be found in the state’s health-care policies and labor statistics. For example, the CPPP reports that compared with other states, fewer Texans are covered by public programs. The state has a total of 5.7 million uninsured, about 1.5 million of whom are children. More than half of these children are eligible for Medicaid or the Children’s Health Insurance Program but are not enrolled. On top of that, fewer people receive benefits through their employers, because fewer of them work full-time jobs. “The housing boom has been great,” DeLuna says. “But it has mostly provided seasonal work —the kind that doesn’t come with health insurance.”
There’s a second point in remarks like those Goodman and Hutchinson made, an implication that opening our emergency rooms to undocumented immigrants siphons valuable health-care dollars away from U.S. citizens and toward undocumented immigrants, and that in turn that prevents the state from covering more people. There may be some truth to this, but according to the Texas Hospital Association, many of the undocumented patients who wind up in the state’s emergency rooms actually pay. Cash. Other studies indicate that many of the uninsured who use the state’s emergency room as a primary-care facility are actually citizens, not undocumented immigrants.
The Gallup results are based on more than 178,000 telephone interviews conducted between January and June of this year. New Mexico and Mississippi were close behind Texas, with 25.6 percent and 24 percent, respectively. At 5.5 percent, Massachusetts, where residents are required by law to carry insurance, had the least uninsured. (The Gaggle has more on the findings.)
In general, states in the northeast have managed to insure the highest proportion of residents, while states in the south and west have insured the least. The Gallup organization also reported that in many states the number of uninsured is up from last year, a finding they attribute to rising unemployment and massive budget shortfalls.
