Texas ranked 36th on an annual measure of the health of each state released recently.
The cynically inclined might respond with surprise that the state ranked that high, given that about 25 percent of Texans lack health insurance and also given how poorly the state often ranks on education, poverty and other health measures. But Texas has relatively few drug and cancer deaths compared with many other states. Texas also is kept at the top of the bottom third of the health rankings by Mississippi and other Southern states that annually occupy the rankings’ bottom 10.
There’s never any comfort in knowing that we’re not Mississippi. And Texas’ position this year on America’s Health Rankings, an annual assessment by United Health Foundation, is a notch lower than last year’s 35th. Texas might never join the ranks of the healthiest states as long as our political leaders remain reluctant to expand health insurance, fail to keep education funding on pace with population growth and choose to not promote efforts to improve the state’s low rates of physical inactivity and lower its high rates of obesity and diabetes.
One takeaway from the rankings is there is a strong connection between health and education. The more education a person has, the more likely he or she is to have a job that offers health insurance and the less likely he or she is to smoke or be obese.
The healthiest ranked state was Hawaii. The political leanings of each state stand out when looking at the list of the top and bottom 10. The 10 least healthy states are generally conservative, while eight of the 10 healthiest states are more liberal. Most of the states in the top 10 chose to set up their own state insurance marketplaces under the Affordable Care Act, unlike Texas, and also used the health reform law to expand Medicaid.
The health rankings coincided with news last week from the U.S. Department of Health and Human Services that 14,038 Texans signed up for health insurance on the Affordable Care Act’s federally run marketplace between Oct. 1 and Nov. 30. Nationally, 364,682 Americans have signed up for private insurance coverage under the health care law as of Nov. 30, according to the Obama administration.
The news is a sign that the HealthCare.gov website is moving beyond the troubles that plagued it upon its launch Oct. 1. Still, last week’s numbers remain far below the 1.2 million that officials had projected would enroll nationwide by the end of November.
Unlikely to help matters is the fact that Gov. Rick Perry and state legislators not only refused to set up a state-run insurance marketplace but also refused to expand Medicaid coverage to low-income Texans. Expanding Medicaid would have brought a million or more Texans into the ranks of the insured.
The Affordable Care Act was written with the assumption that the states would expand Medicaid to the working poor. When the Supreme Court allowed states to opt out of the law’s Medicaid provision, it created a gap that prevents members of the working poor who make too much to qualify for Medicaid without the expansion but too little to qualify for tax credits on the insurance marketplace from accessing health insurance.
State policymakers should also take note of a third health-related item last week that came from a study published in BMJ, the former British Medical Journal. Researchers found that exercise might be as effective as prescription drugs in treating heart disease, diabetes and other leading causes of death. As the New York Times’ Gretchen Reynolds wrote, “The study raises important questions about whether our health care system focuses too much on medications and too little on activity to combat physical ailments.”
Opponents point to the expense of efforts to expand and improve education and health care and to promote exercise and healthy diets, but these efforts can control costs and have long-term benefits for individuals and the state. Pursued, they also might one day give Texans something to brag about when it comes to their own health.