The coronavirus outbreak in Bexar County has slowed, but the death toll continues to rise.
About 766,000 Texans fall into what’s called the Medicaid coverage gap. Credit: Bonnie Arbittier / San Antonio Report

I’ve spent my entire career helping families in need get access to health insurance. And I’ll never forget the desperate measures taken to help a 35-year-old cancer patient who had just moved to my hometown of San Antonio to live with her brother after Hurricane Irma hit her home in the U.S. Virgin Islands. 

In the Virgin Islands, she qualified for Medicaid and was receiving life-saving chemotherapy treatment. But as soon as she became a resident of San Antonio, her Medicaid services were cut because of our state’s stringent rules limiting who qualifies. I worked with her several months before she finally got approval for Medicaid and would be able to get the care she needed. But help came too late. I received her Medicaid card in the mail a week after her death.

I wish I could say this was a rare occurrence, but sadly, I’ve seen many wonderful people who desperately needed care die from lack of health coverage. 

Currently, 766,000 Texans fall into what’s called the Medicaid coverage gap because our state legislature has repeatedly refused to expand Medicaid. That means their incomes are too low to qualify for subsidies to purchase insurance in the Affordable Care Act marketplace, but they also don’t qualify for Medicaid under our state’s strict rules and requirements.

And our members of Congress have the power to change this. The Build Back Better plan currently being debated in Congress presents an opportunity to close the Medicaid coverage gap and ensure hundreds of thousands of Texans have access to the affordable care they need.

I know firsthand what a difference this will make for San Antonio families. I work every day to connect folks in our community with the care they need, but I can only do so much when our state’s policies are working against me. Our members of Congress must stand up for all the Texans who need health insurance and ensure they pass a package that closes this coverage gap.

I don’t want to have to console another person coming to me for help who tells me that dying is not even the worst outcome for them. When you lose a limb, develop hernias, get cancer or have a plethora of other health problems, not having insurance puts a financial and mental strain on your family that can endure for generations. It breaks my heart that people worry about becoming a burden to their families because they can’t afford the care they need. No matter how many resources we provide, our current system has continually brought us down.

Our members of Congress have the power to help by passing Build Back Better and closing the coverage gap. If passed, more than 2 million uninsured adults across the country with incomes below the poverty line would be able to enroll in ACA marketplace plans in 2022 without paying any premiums. 

I can’t wait for the day when I no longer have to see families lose loved ones because they can’t access affordable care. I can’t wait to finally tell the families in San Antonio that they do qualify for insurance, and I can help them. Most importantly, the 766,000 Texans without insurance can’t wait. 

Olga Kauffman

Olga Kauffman is a San Antonio-based community activist that provides resources for Texans who fall under the Medicaid coverage gap.