Closing the Coverage Gap

$7.9 BILLION. That's a lot of money.

And, that's what Texas will lose in 2016 by not closing the coverage gap for uninsured Texans earning less than poverty wages.

$251 per second
$15,065 per minute
$903,903 per hour
$21,693,672 per day

$661,657,003 per month 1

It adds up second by second, minute by minute, day by day, year by year in enormous quantities of lost federal funding and in the health, well-being and economic productivity of an estimated 766,000 adult Texans2

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The Coverage Gap
Uninsured, low-income workers making between 100 and 400 percent of poverty can now receive subsidies to help purchase affordable health coverage in the Health Insurance Marketplace. However, 
   because of Texas’ decision to turn down federal funds to expand health coverage under the Affordable Care Act (ACA), uninsured Texans earning less than poverty wages are left without affordable coverage options. More than three-quarters of a million of the state’s poorest adults have been left in this coverage gap, relying on safety net providers like community health 

centers to provide access to primary care services. When safety net services aren’t available, or if services beyond primary care are needed, lack of health coverage and access leads to delay of care and use of emergency rooms for routine care, increasing costs in the health care system in the long term.

Texas Pays Anyway

Texas taxpayers are already picking up the tab for health care for low-income Texans, but we are paying for it three times: through federal taxes we pay regardless of coverage expansion, sales taxes that fund state indigent health care programs and property taxes that pay for hospital uncompensated care and county indigent care programs. This patchwork of coverage is wasteful, inefficient and expensive. Alternately, under a coverage expansion federal taxes would not pay less than 90 percent of the cost of care for the coverage gap population, freeing up state and local resources for other purposes. Texans are paying these federal taxes anyway, but they are being redistributed instead of coming back to Texas. This loss of federal funds equals a $16 billion loss for Texas taxpayers between 2014 and 2016.

A majority of states have already solved this problem. Texas must find a solution to accept federal funds to provide health coverage to our low-income residents that saves money in the health care system, eases local tax burdens, ensures Texas taxpayer dollars are funneled back into the Texas economy, eases burdens on the existing safety net and promotes a stronger, healthier Texas. 

Learn More & Get Involved

Community Health Centers in Texas Need Your Help. Coverage And Access To Affordable Health Care For Thousands Of Our Neighbors Is At Stake.  Sign up here to join a community working to make your community a healthier place for everyone.


1 Estimates based on State Fiscal Year 2014 federal funds. Source: HHSC, "Impact to Texas Medicaid of ACA Implementation by Levels of Implementation," (spreadsheet), August, 2012.
2  Kaiser Family Foundation, The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid – An Update, Oct 23, 2015,