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The Majority Of Texans Want Medicaid Expansion, Poll Shows

A new poll from the Episcopal Health Foundation shows that Texans have consistently supported Texas expanding Medicaid under the Affordable Care Act despite opposition from the Republican-led government. 

Texas has the dubious honor of leading the United States in terms of raw numbers of residents without medical insurance of any kind. The Texas Medical Association estimates that 5 million Texans lack coverage, including 1 million children. The Medicaid expansion for states that was passed as part of the 2010 Affordable Care Act would immediately cover 1.4 million Texans, with the federal government handling more than 90 percent of the cost. As it stands right now, Texas has some of the stingiest requirements in the country. Most adults do not qualify no matter how small their incomes are.

This has led to a lot of Texans feeling dissatisfied with healthcare in the state. The vast majority (76 percent) say that making healthcare more affordable is “very important” according to the EHF poll. Only education and crime ranked higher as priorities. 

Nealy half (48 percent) said it’s very difficult to afford healthcare, and that number jumps to 51 percent when it comes to people under the Medicare age of 65. A majority (59 percent) said they have skipped care because of the cost associated. 

Meanwhile, support for expanding Medicaid is at an all-time high of 69 percent. EHF has been tracking the question since 2019, and it has only gone up from its first finding of 64 percent. 

“The bottom line on all these polls is that it’s tough to afford care and tough to access care without insurance,” says EHF chief communications officer Brian Sasser. “Expanding Medicaid under the ACA would be the biggest thing that the state could do. The misnomer of Medicaid is that if you’re poor in Texas you get free care, but that’s not true. It’s mostly children and pregnant mothers. Most adults are not covered by Medicaid by now. The ACA gave that window to states, and all but twelve have taken it. It’s a frustrating dilemma. People probably have the idea that it’s there for them and it’s not.”

Confusion about the issue is also apparent from the EHF numbers. Some 60 percent of Texans either think the state has already participated in the Medicaid expansion or is unsure. 

“It’s confusing for some people,” says Sasser. “If you explain what the program is and the amount of federal dollars supporting it, it would be even more popular. If you put yourself in the shoes of someone working at a grocery store without insurance, they might not know the difference between ‘Obamacare’ and Medicaid. I don’t think people know the ins and out of the stuff and it’s a little overwhelming.”

The widespread public support might have finally started to put cracks in Republican opposition. This past legislative session at least saw bipartisan support in the Texas House for fully embracing the Medicaid expansion. Unfortunately, the matter died in committee in the Senate and was ultimately not passed. The legislature did pass one small expansion, offering another six months worth of post-natal care to birth parents whose children are on Medicaid.

Jef Rouner
Jef Rouner
Jef Rouner is an award-winning freelance journalist, the author of The Rook Circle, and a member of The Black Math Experiment. He lives in Houston where he spends most of his time investigating corruption and strange happenings. Jef has written for Houston Press, Free Press Houston, and Houston Chronicle.


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