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A Gateway to Equitable Health Care Access

YI advocated expanding healthcare access for young people, including auto-enrollment into Healthy Texas Women for 19-year olds aging out of Medicaid, state Medicaid expansion, and continuous coverage. In addition to legislative meetings, young advocates testified on Healthy Texas Women auto-enrollment and spoke on the importance of Medicaid expansion in increasing access to healthcare for young adults. One of our young advocates, Stephany Ibarra, who hopes to continue working in health policy shared her experience of working on health care expansion for women in Texas like herself. Check out more reflections from our young advocates on their work in the Texas legislative process.

During the 86th Texas legislature, there were many attempts by both representatives and senators to find an alternative solution to Medicaid expansion—the part of the Affordable Care Act where states can choose to cover more people under their Medicaid programs with financial help from the federal government. With the current state of politics in Texas, a more openly progressive solution would have been unlikely to pass a committee vote, and even less likely to pass a House or Senate floor vote. In an attempt to find a solution that would gain bipartisan support, the Healthy Texas Women Auto-enrollment bill (HB 1879) was created. Many of the people who proposed and helped advocate for this bill saw this piece of legislation as the spark to the flame of future comprehensive health care. This bill proposed expanding health care access to young women who aged out of CHIP or Medicaid. Due to the 2011 budget cuts, the defunding of Planned Parenthood, and the refusal to expand Medicaid, many Texans have been left with little to no access to health care services. In order to fix these regressive policies, state programs such as “Healthy Texas Women” and the “Family Planning Program” were created to serve as solutions for equitable health care access. 

Given this situation, HB 1879 sought to auto-enroll young women aging out CHIP and Medicaid into the Healthy Texas Women program. This is not a radical new proposal; this auto-enrolling process already exists for pregnant women coming off Medicaid after their pregnancy. All this bill asked, was for this same procedure for young women who would inevitably fall into the Medicaid gap that exists in Texas today. Although this bill primarily served young women, it’s still a step towards creating greater access to health care services. Healthy Texas Women is a great program that provides many services such as mammograms, STI testing, contraceptives, and various health screenings. While state programs like Healthy Texas Women provide vital treatments, they should not be seen as replacements for comprehensive health insurance. Both of the Texas programs mentioned create greater accessibility to some health care services, but they do not provide coverage for all of the treatments that a health insurance plan would. 

It is important to recognize the health care gap that affects many young people in Texas. Due to their age, they no longer qualify for Medicaid or CHIP and often don’t qualify for the tax credits on health insurance plans offered through the Marketplace (an initiative created by the Affordable Care Act). I’ve been directly affected by these policies. I don’t have health insurance because I simply can’t afford it on a monthly basis, as I am also currently paying my own way through college. Many people are fortunate to be covered by their parent’s health insurance plan until they are 26 years of age, but that’s not the case for me.

Although programs like Healthy Texas Women exist, I was not aware of their services until I began doing advocacy work this year. The implementation of HB 1879 would have been a great way of letting young women in Texas know of the services offered to them if they qualified for this program. I have searched far and wide for any type of access to health care services, and not once did I ever run across this program throughout my searching. 

Through my advocacy work with Young Invincibles and partner organizations, we found substantive support for this bill from both sides of the aisle. Meeting with legislators and their staff allowed us to not only advocate for our concerns but hear theirs as well. This opportunity ultimately helped us create a dialogue among legislators who may have otherwise not considered our position. During this process, I was able to tell my own story about being someone in the Medicaid gap, and how the lack of health insurance has affected me. Even though not everyone empathized with our stance on health care, it was a privilege to be in this position where I was able to directly appeal for my concerns.  It was something I never thought I would have the opportunity to do. I’m glad I was able to share my story, and hopefully, it echoed the voices of other uninsured Texans. 

Furthermore, the work put in by my colleagues and me through various meetings with legislators, and committee testimonies were not in vain. Our hard work paid off as HB 1879 was actually voted out of the Public Health Committee with a unanimous vote of 11-0; however, we never saw it get to the House floor for a vote. We hope that in the future, with the information gathered this legislative session and the bipartisan support we had for this bill, we can see this same support towards other bills creating inclusive health care for all.

Stephany Ibarra attends the University of Texas at Austin, where she’s majoring in Political Communications and Anthropology.