Texas Has a Lot to Lose with a Full ACA Repeal

//Texas Has a Lot to Lose with a Full ACA Repeal

This post was written by Melissa McChesney and it’s the third post in our Countdown to Coverage series. 

Since the ACA was implemented, Texas has seen historic reductions in the number of uninsured in our state. From 2013 to 2015, the uninsured rate in Texas dropped a total of 5 percentage points, with 1.1 million fewer uninsured Texans. But all of the ground we’ve gained, and the path to further progress are both at risk with a full repeal of the ACA.

But We Don’t Have to Go Quietly

There are two things consumers and advocates can do right now to help protect the gains we’ve made.

  • First, get the message out that the Marketplace is still open and people should still enroll in 2017. It is likely that Congress will begin to make some changes to the ACA law as soon as January, but it very unlikely that those changes would take immediate effect. Health plans are already contractually locked in for 2017; however, consumers may not understand that this, and may assume that they are no longer required to be covered or that the coverage is likely to go away during 2017.
  • Next, join the fight. The president-elect said on the campaign trail that he wanted everyone covered with even greater affordability than the ACA: let’s hold him to that promise! Pick up the phone and call your U.S. Let them know you are watching, and that you care. As mentioned above, changes could start as soon as January. Congress needs to know now that there are real Texans who depend on their insurance. Whatever changes are made, they should remain covered.  No Repeal Without Replace!  What’s Your plan?

For more information on how you can join in advocacy for health access in Texas go to CoverTexasNow.org.

A full ACA repeal threatens access to healthcare for 3 million Texans (now or in the future), including:

  • 1 million Texans who purchase their insurance coverage on the Marketplace with 84 percent receiving financial assistance to lower their premium amount. This includes more than 100K children.
  • 900K Texans could get help paying for coverage in the Marketplace in 2017 if they sign up. An estimated 17 percent of uninsured Texans are eligible for help paying for coverage on the Marketplace. Another 250,000 Texans who currently purchase individual insurance for full price outside of the Marketplace could get tax credits to reduce their costs—if they switched to a Marketplace plan.
  • 864K uninsured adults who could gain health insurance under the ACA if Texas choses to expand Medicaid or use Medicaid funds for an alternative coverage approach—but this option is also at risk with an ACA repeal.

This tally doesn’t even include the Texans who gained access to affordable insurance due to the ACA guarantee of coverage for individuals with pre-existing conditions, or the requirement to allow young adults to stay on their parent’s plan until age 26.



Melissa joined the Center in 2015 and works remotely from Houston. She focuses on policy and practice related to outreach and enrollment for the Affordable Care Act (ACA) health insurance Marketplace, Medicaid, and the Children's Health Insurance Program (CHIP), including access to coverage for immigrants. Melissa has provided policy analysis, training, and troubleshooting guidance to health care enrollment assisters across Texas. Prior to joining the Center she worked as a Senior Policy Analyst for the Texas Health and Human Services Commission on the team that implemented eligibility changes to the Medicaid and CHIP programs required by the ACA. Melissa earned a Master of Science in Social Work from the University of Texas at Austin and a Bachelor of Science in Sociology from the University of Central Arkansas.

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