The country’s medical debt crisis is at its most dire in several parts of Texas, which is home to three of the worst 10 U.S. counties for medical debt, according to data analyzed by the Urban Institute.
In each of those communities -- Haskell County, Pecos County and Nolan County -- the share of residents with outstanding delinquent medical bills is at least three times as high as the U.S. average.
Gary Floyd, president of the Texas Medical Association, said Texas’ high uninsured rate results in too many people avoiding preventative care and only accessing the healthcare system through emergency visits. “It's a little disconcerting that our country doesn't provide us with the resources to take care of people like her, with her needs,” said Mais’ mother and caretaker, Dolly Francis.
A bill that would have expanded Medicaid died in 2021 after failing to receive enough support, despite it having some Republican backers and a large coalition of support outside the statehouse. Largely, the failure to expand Medicaid in Texas is a political decision, Dunkelberg said, which disproportionately impacts Texans of color.
“We’ve been successful in targeted approaches,” Floyd said. “As far as why Medicaid has not been expanded, I’d have to refer you to our legislators.” “What gets measured gets fixed,” Bettencourt said. “It’s a way for the public to have transparency about their medical bills. It’s just Texas common sense.”
“It’s better than nothing and there are a handful of counties where it’s really meaningful,” Dunkelberg said. “You’ve got a fair amount going on in the Rio Grande valley. Waco has a pretty significant indigent care program. But it’s limited in scope.” “Hospitals are front and center, providing life-saving treatment to people, regardless of their ability to pay,” Williams said.“A patient who is eligible for charity care can still end up with a bill, and possible debt,” Williams said. “For instance, if a hospital has a sliding scale charity care policy and a patient gets an 80% discount on their bill, the patient is only responsible for the remaining 20% of the bill.
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