In addition to the high number of working poor adults in the Border region who cannot afford health insurance, Texas now has an estimated 1.4 million uninsured children. The Border region is home to more than a quarter of this young uninsured population. In El Paso alone, there are an estimated 72,797 children without health insurance. Under the current Medicaid Managed Care and CHIP Programs, reimbursement rates are determined by reviewing the utilization rates of each area or region of the state. Unfortunately, any geographic area with limited access to health care facilities and providers will produce low utilization rates.
Access is limited in the Border region because there is a lack of adequate medical infrastructure.
Further, many of our citizens get medical care in Mexico, so these costs are never captured. The following chart demonstrates to some extent these disparities. As Medicaid managed care is rolled out across Texas, low rates will extend to many other areas of the state and compound disparities already extant in San Antonio, Laredo and the Valley. For no other reason than historical precedent, physicians in one part of the state will be unjustifiably expected to cover a greater burden of the expense of caring for patients than their counterparts in other areas. This policy does not make sense, nor will it motivate providers to continue serving Border cities or to open new practices in the least medically served counties in the United States.