Texas still leads nation in rate of uninsured residents

By JASON ROBERSON / The Dallas Morning News
jroberson@dallasnews.com

Texas once again led the nation with the highest percentage of residents without health insurance, a U.S. Census Bureau report showed Tuesday, although the same study also reports a slight dip last year in the percentage without coverage across the nation.

Almost one of every four Texas residents – 24.8 percent – were uninsured in 2006 and 2007, based on an average of the rates for those two years. That's up from 23.9 percent for 2004 and 2005.

The national number also increased a bit for the two-year period to 15.5 percent. However, looking at 2007 by itself, the percentage of uninsured in the country fell from 15.8 percent in 2006 to 15.3 percent in 2007. (State percentages were given only for two-year periods.)

California still has the highest number – not percentage – of uninsured residents at 6.7 million, compared with 5.7 million Texans. The Texas number is up from 5.5 million in 2006.

McCain adviser

But the numbers are misleading, said John Goodman, president of the National Center for Policy Analysis, a right-leaning Dallas-based think tank. Mr. Goodman, who helped craft Sen. John McCain's health care policy, said anyone with access to an emergency room effectively has insurance, albeit the government acts as the payer of last resort. (Hospital emergency rooms by law cannot turn away a patient in need of immediate care.)

"So I have a solution. And it will cost not one thin dime," Mr. Goodman said. "The next president of the United States should sign an executive order requiring the Census Bureau to cease and desist from describing any American – even illegal aliens – as uninsured. Instead, the bureau should categorize people according to the likely source of payment should they need care.

"So, there you have it. Voila! Problem solved."

Mr. Goodman's analysis drew a sharp response from the Center for Public Policy Priorities, an Austin-based think tank focusing on poverty issues. "That is not the same thing as having health insurance," said Eva Deluna, a budget analyst for the center. People without insurance are less likely to seek care, and when they do, the cost to the health system is greater, she said.

Fight on statistics

According to Mr. Goodman, only people who are denied care are truly uninsured – everyone who gets care is effectively insured by some mechanism. "So instead of producing worthless statistics that people fling around in vacuous editorials and pointless debates, the Census Bureau should produce meaningful numbers, identifying all of the sources of funds people will draw on if they need medical care," he said.

Ms. Deluna argued that the situation actually is worse now than the Census Bureau reported. The just-released data does not reflect the recent economic downturn, she said.

It makes no sense, she continued, for Texas to have the nation's highest percentage of uninsured residents, while having one of the nation's strongest economies for job growth.

In luring jobs to Texas, state and local officials have simply focused on the number of jobs, rather than on quality jobs offering health insurance, Ms Deluna said.

"People are working harder than ever, but the jobs they have don't provide health insurance," she said.

The number of Texans receiving health insurance through their jobs dropped to 11.9 million last year, from 12.1 million the year before, according to the Census Bureau.

Nationally, the overall number without insurance fell to 45.7 million last year, from 47 million in 2006.

The decline came as more Americans shifted to government Medicaid and Medicare coverage, said Ron Pollack, executive director of Families USA, a nonprofit health care advocacy group in Washington D.C.

An estimated 1.3 million additional people signing up for Medicaid and 1 million more signing up for Medicare were the main drivers of the lower uninsured rate, he said. "Ironically, this all happened while the president was trying to cut back on Medicaid," Mr. Pollack said.

Household incomes

In other findings, the report said:

• The nation's official poverty rate in 2007 was 12.5 percent, unchanged from 2006. However, the number of Americans living in poverty grew to 37.3 million in 2007, up from 36.5 million in 2006.

• Real median income, adjusted for inflation, rose for both black and non-Hispanic white households between 2006 and 2007, representing the first real increase in annual household income for each group since 1999.

• Among racial groups, black households had the lowest median income in 2007 at $33,916. That compares with a median of $54,920 for non-Hispanic white households. Asian households had the highest median income, $66,103. The median income for Hispanic households was $38,679.

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