Twelve years after studying the personal situations of people without health insurance, Sociology Professor Susan Sered revisited many of the families and individuals interviewed for her 2005 book Uninsured in America: Life and Death in the Land of Opportunity to examine how the Affordable Care Act impacted them.
In the article “Uninsured in Texas, Then and Now,” published in the September issue of Health Affairs, Sered focuses on Luis and Daniela and discusses the “consequences of political inaction” in their inability to afford health insurance; their state “chose not to adopt the ACA’s Medicaid expansion.”
Daniela continues to be the sole caretaker for an adult daughter who is disabled, lifting her and engaging in other physical tasks despite the aftereffects of a ruptured disk in Daniela's back. Luis earns $1,500 a month as a full-time truck drive, but his employer does not offer health insurance, and his earnings are too much for the family to qualify for Medicaid.
“Without the Medicaid expansion that would have given Texas families a measure of health security, families continue to struggle with a chaotic fragmentation of care,” writes Sered. “Most of the people I spoke with in the Rio Grande Valley blamed ‘Obamacare’ for not meeting their needs. …With the exception of a handful of activists, no one I met … was aware that the Texas state government had declined to participate in the Medicaid expansion, even though the federal government is picking up nearly all of its cost.”
She goes on to cite evidence that Medicaid expansion in Texas “would have resulted in an estimated 184,192 fewer diagnoses of depression, 62,610 fewer individuals with catastrophic medical expenditures, and 1,840-3,035 fewer deaths in 2013.”