AUSTIN, Texas (AP) — Two South Texas counties have among the highest rates of people without health insurance in the nation, with working Hispanic men in South Texas the most likely to not have coverage, according to data released Thursday by the U.S. Census Bureau.
Hidalgo County has the highest rate among urban counties at 38.9 percent, and Maverick County has the highest rate among medium-sized counties at 35.1 percent.
Texas continues to have the highest uninsured rate in the country, with about one in four people having no coverage of any kind. Massachusetts, which requires residents to have coverage, has the lowest uninsured rate in the nation at 4.9 percent.
The Census Bureau's Small Area Health Insurance Estimates are a statistical analysis of the American Community Survey data and other census information combined with federal income tax, Medicaid, food stamps and County Business Patterns records. The dataset is for 2011, the latest year available.
There are vast differences in uninsured rates based on location, ethnicity, income, gender and age. Hispanic males were the least likely to have health insurance nationally, but in Texas the rate was 67.4 percent of Hispanic men between the ages of 18-64 who earn less than $23,000 a year. That is an estimated 950,000 people.
Under the Affordable Care Act, 320,000 of those men will be required to purchase subsidized health insurance, but because Gov. Rick Perry rejected a federal plan to expand Medicaid to include the working poor, more than 630,000 men will not be eligible for the health care program for the poor or subsidized insurance because they make too little.
Texas Medicaid is primarily for children, the disabled the elderly poor, with very few childless adults eligible.
The uninsured rate for white men with the same income was only 42 percent, or 303,000 people. The rate for blacks was 47 percent, or 155,000 men. Among Texas's most populous counties, Dallas County had the highest rate at 30.5 percent, but Harris County had the most people at more than 1 million.
The five counties with more than 25,000 residents that had the highest uninsured rates were all in South Texas ranging from 34.6 percent in Starr County to 38.9 percent in Hidalgo County. For Eddie Olivarez, chief administrative officer of Hidalgo County's Health and Human Services department, the numbers were all too familiar.
"We always wind up being one, two or three," he said.
The rate is the result of the county's transition from an agriculture-based economy to a service-oriented one, and its location on the Texas-Mexico border, he said. Hidalgo has a fast-growing population, but not the kinds of jobs that offer private health insurance.
So Hidalgo County is one of many counties across the state to pass resolutions calling for the expansion of Medicaid to include the working poor. Otherwise, those individuals end up in local emergency rooms where local residents have to pick up the tab either through higher county taxes or higher premiums on their private insurance.
Perry and other Republican leaders, though, remain adamantly opposed.
"Texas measures its health care success by the options that are provided for coverage, and the efforts to create ones that are affordable," Perry spokesman Josh Havens said. "Medicaid is a broken system, and we think it would be irresponsible to expand a program that is unsustainable."
Perry has instead called on the federal government to provide Texas with all of the available federal funds for Medicaid without any strings attached. Perry rejected a federal proposal to expand the existing Medicaid system with the federal government providing $100 billion over the next 10 years in return for the state spending $15 billion.
In the meantime, the Rio Grande Valley is pinning much of its hope on the planned University of Texas medical school. The area's hospitals and municipalities have banded together to drive the project with the idea that the new doctors it will churn out will increase access to health care, Olivarez said.
AP Correspondent Chris Sherman contributed to this story from McAllen.
On the Internet: Small Area Health Insurance Estimates: http://www.census.gov/did/www/sahie/index.html
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