The recently enacted American Rescue Plan Act of 2021 (ARP) includes new large financial incentives for states to extend health insurance coverage to low-wage workers and other
adults earning less than $17,775 a year.¹ These incentives apply to regular spending in a state’s Medicaid program and offer a five-percentage point across the board increase in the federal share for a 24-month period after the state extends coverage. The Kaiser Family Foundation estimates that Texas’s budget would see a net gain of $1.9 billion over a two-year period if the state expanded Medicaid.² Approximately 1.4 million uninsured nonelderly adults, or 34 percent of the state’s uninsured adult population, would gain health insurance.³
This fact sheet examines which workers and industries would benefit from expansion of Medicaid coverage.4 The top three industry sectors employing low-wage uninsured workers are hospitality, retail, and health care and social assistance, accounting for almost half (48.5 percent) of those working without insurance (see Table 1). Businesses with a large proportion of uninsured low-wage workers include restaurants, construction firms, and home health care agencies. The most common jobs for low-wage, uninsured workers in Texas are cashiers, cooks, waiters and waitresses, retail sales, and personal care aides (see Table 2).
¹ For more information on the provisions of the law, see E. Park and S. Corlette, “American Rescue Plan Act: Health Coverage Provisions Explained” (Washington DC: Georgetown University Center for Children and Families and Center on Health Insurance Reform, March 2021), available at https://ccf.georgetown.edu/2021/03/11/american-rescue-plan-act-health-coverage-provisions-explained/. Low-income individuals defined as those earning less than 138 percent of the Federal Poverty Line—approximately $17,775 for an individual or $30,305 for a family of three. Workers defined as those who report industry and occupation information on the American Community Survey. Contact authors for more information on sources of data and methods.
²R. Rudowitz, B. Corallo, and R. Garfield, “New Incentive for States to Adopt the ACA Medicaid Expansion: Implications for State Spending” (Washington DC: Kaiser Family Foundation, March 2021), available at https://www.kff.org/medicaid/issue-brief/new-incentive-for-states-to-adopt-the-aca-medicaid-expansion-implications-for-state-spending/.
³Kaiser Family Foundation, “Who Could Medicaid Reach with Expansion in Texas?” (Washington DC: Kaiser Family Foundation, February 2021), available at https://files.kff.org/attachment/fact-sheet-medicaid-expansion-TX.
4 Contact authors for more information on sources of data and methods. All data are derived from the American Community Survey (2019) most from the Public Use Microdata Sample; county data calculated from American Community Survey five-year (2015-2019) prepared tables.