Describe your state’s position on Medicaid expansion. How has this helped/hurt health care in your state?
Texas is among the 11 states yet to adopt and implement Medicaid expansion. This decision has caused serious, devastating impacts on residents, especially those with incomes below federal poverty levels. As ACA was written, it required the states to expand Medicaid for all legal residents whose income was below 138% of the federal poverty level (Health Insurance. Org, 2023). This would ensure that individuals who previously could not qualify for enrollment into Medicaid would be accepted and have medical insurance. However, the supreme court ruled that states that did not include Medicaid expansion would not be penalized, and Texas chose not to adopt the expansion (Health Insurance. Org, 2023).
This decision has had several negative impacts on the residents of Texas. The state has the biggest coverage gap, with more than 771 000 residents being ineligible for Medicaid or the premium subsidies to meet the cost of private coverage (Health Insurance. Org, 2023). As of 2020, 45% of adults between 19-64 years with poverty levels below 138% were uninsured. This is because Texas still uses the initial laws, such as non-disabled adults without minor children cannot be covered by Medicaid regardless of having an income below the federal poverty level (Health Insurance. Org, 2023). Parents with minor children can only be covered if the children are enrolled in Medicaid and the household income is less than 14% of the poverty level. Lack of health insurance is often associated with several poor outcomes, including limited access to healthcare services and high morbidity and mortality rates. For example, in Texas, pregnancy-related coverage ends two months after childbirth, which is associated with higher maternal morbidity and mortality rate in the state. It is, therefore, critical that the legislator reviews the laws to allow for Medicaid expansion (Health Insurance. Org, 2023).

References
Health Insurance. Org, (2023), Medicaid eligibility and enrollment in Texas: Lack of Medicaid expansion and stringent eligibility requirements drive highest uninsured rate in U.S. Retrieved from: https://www.healthinsurance.org/medicaid/texas/