Millions of uninsured Texans have health coverage options and they may not know it

HOUSTON, Texas (KTRK) -- Texas leads the nation with its health uninsured rate, but a study shows it doesn't have to be that way, and millions of Texans are missing out on free or reduced rate coverage.

Not having health insurance can take its toll

Sitting in a doctor's office hasn't always been the best place for Calvin Deghelder. "It's just so much stress from not being able to figure out where the next dollar is going to come from to pay for your medical needs, especially when you don't have insurance," Deghelder explained.

Deghelder said after family members suffered medical emergencies not having health insurance quickly added up. "Literally, hundreds of thousands of dollars," Deghelder recalled.

In order to pay the bills, and keep the collection callers away, Deghelder said he had to sell his home.

"It ate up all of our savings," Deghelder recalled. "I was scared. I didn't know if we were going to wind up in the street or not."

Texas leads the country with its uninsured rate, and it's not even close

In Texas, this is a story that could be told by more people than another other state. U.S. Census data shows more than 16 percent of Texans don't have insurance.

No other state is higher than 12%. To find out why, Texas 2036 studied the uninsured.

"While it's getting better, we're still in last place and there's a lot of work to be done," Texas 2036 policy director Charles Miller said.

Miller said Texans may not have insurance because they don't have a job, their employer doesn't offer health insurance, or it costs too much money. It's an issue impacting one group more than others.

Hispanics make up 40% of the state's population, but 63% of those who don't have health insurance.

"One of the potential reasons that we did identify that is a common reason why folks were citing to us as to why they might have been eligible but unenrolled is concern over the impact this might have for family or household members who are undocumented," Miller explained.

Millions of Texans could get free or reduced health insurance, but experts found many don't know about it

Private chef Shawn Kingsley used to not worry about going to the doctors. "You don't think about it. You do not think about what you can and cannot do," Kingsley explained.

That changed after Kingsley lost his job and benefits. "Not having coverage, it's scary," Kingsley said. "It's scary because you don't know where to go and what to do."

Kingsley's anxiety subsided when he discovered Legacy Community Health. The non-profit works with patients who don't have insurance.

One way is by helping patients learn about healthcare options. Kingsley learned about plans through the Affordable Care Act, or healthcare.gov.

"A lot of times it's a common thing that they're unaware that they can access these services," Legacy Community Health eligibility manager Celina Guajardo explained. "When we go in and explain their options and try to find them a program, they're very happy with the results."

The group Texas 2036 said one reason why Texas leads the country in the uninsured rate is people don't know about these options.

"A lot of folks thought that they had to have a job in order to insurance and there wasn't awareness that there was such a thing as the individual market where they could sign up," Miller explained.

The group found 30% of uninsured Texans, or 1.5 million people, qualify for free healthcare through the Affordable Care Act. Another 33% could qualify for reduced costs.

The Centers for Medicare and Medicaid Services agency said four out of five who qualify for discounts find plans for $10 or less per month.

Miller said making more Texans aware of Affordable Care Plans instead of expanding Medicaid could make a bigger difference in driving numbers down.

"If folks had gone to sign up on the individual market a few years ago, maybe they were finding that it was too expensive, but things have changed," Miller explained.

There are other options for people without coverage outside of the ACA

Experts said even if you have insurance, Texas' large number of uninsured impacts everyone. "This can cause high wait times at the emergency room when people are using those as a source for primary care when they feel like they don't have access to more appropriate settings of health care," Miller explained.

One of those places trying to change this is TRS Health in Stafford. 95 percent of the patients don't have health insurance. It's a service that's grown tremendously since the clinic opened four years ago.

"We pretty much went from seeing 500 to 600 patients in our first year to we've seen more than 10,000 now," TRS health administrative director Haroon Waseem said.

TRS Health offers primary care services, image specialists, and even a pharmacy. When patients show up, the costs are upfront.

The non-profit clinic tries to keep them low, with a primary care visit starting at $30.

It's a place Deghelder found a few years ago. After racking up hundreds of thousands of dollars in medical bills, Deghelder said he found a place he can afford and is no longer afraid to visit the doctor.

"I don't have to worry about that stress anymore," Deghelder said. "I don't."

Legacy Community Health is an option too. The group not only works to help people without insurance find coverage, it also offers plans to help people without insurance afford care.

"We have a sliding fee scale program that based on household size and income you can receive discount prices for any and all of our services," Guajardo explained.

If you don't have insurance, another option is to talk to your provider. Ask for a cash pay rate, or if there are financial assistance programs.

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