Texas ranks last in U.S. health care access study

Texas finished last among the 50 states and the District of Columbia for health care access and affordability for its residents, according to a new study by the New York-based Commonwealth Fund.

The analysis, titled the “2019 Scorecard on State Health System Performance,” ranked Texas as the worst in health care access and rated the state 49th overall. The latter ranking resulted from analyzing data in the areas of prevention and treatment; healthy living behaviors; health care disparities; use of services; and system costs.

Texas fared better in the category of health outcomes, according to David Radley, a senior scientist and one of the study’s authors.

“Texas had lower than average rates of adults smoking, which helped it to have a relatively high ranking in this category,” Radley told The Center Square.

The Lonestar State also did better in measures of “depths of despair,” which refers to rising rates nationwide of deaths from alcohol abuse, drug overdoses and suicides. That trend was much less evident in Texas, according to Radley.

“Texas has one of the lowest rates of drug-associated mortality in the country,” he said.

Another more positive trend in Texas involves the share of nursing home residents who are given antipsychotic medications, a controversial treatment used on more difficult elderly patients.

“Texas ranked 27th out of 51 on this measure,” Radley said. “What is great in Texas … is that it’s come down a lot in recent years.”

But he emphasized that a key reason behind the state’s low score overall was that it remains one of the 17 states that have not expanded Medicaid coverage through the Affordable Care Act (ACA).

“The rates in Texas are higher than they are in other states because Texas hasn’t expanded its Medicaid program,” he said.

Critics have charged that expanding health care via Medicaid results in rising state health costs, leads to higher incidents of fraud, and results in a high numbers of people dropping their private insurance to pick up taxpayer-funded Medicaid.

Radley said Texas’ uninsured rate of 24 percent – compared to 4 percent in Massachusetts – leads to other health care problems. These include adults skipping needed care because of costs, lower rates of residents receiving age- and gender-appropriate care and lower rates of cancer screenings, he said.

Texas’ proximity to the U.S.-Mexico border presents challenges for the state in terms of undocumented immigrants not having health care coverage, Radley said.

“Texas has a unique set of challenges that a lot of other states don’t seem to have,” he said.

Read more on The Center Square.