Houston and Dallas claim spots No. 1 and No. 2 on the Census Bureau’s ranking of the largest American cities based on the rates of uninsured residents, followed by Miami and San Antonio.
Texas’ high uninsured rates are connected to the state’s rejection of Medicaid expansion under the Affordable Care Act. With a population of nearly 30 million people, expanding Medicaid in Texas would have a significant positive effect on efforts to increase overall insurance rates in the U.S., according to the report.
However, continuing to reject Medicaid expansion leaves millions of people in the state without health insurance, leading to an increased strain on the state’s medical system, according to the report. Many people without insurance either turn to emergency departments for basic care or allow serious chronic conditions to go untreated and get worse.
“The system is unsustainable,” Kristie Loescher, a healthcare policy expert at the University of Texas in Austin, told Vice. “You’re cutting off a vital aspect of productivity in your communities by having people who are having to deal with illness and things like that without care.”
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