In Texas, where health insurance is most lacking, free clinic draws big crowds, but doctor says it's 'peeing in the ocean'

Dr. Doug Curran (Photo by Blaine Young/Public Health Watch)

Low-income Texans have less access to health care than residents of any other state, report Kim Krisberg and David Leffler for Public Health Watch and The Texas Tribune. Nearly 18% of Texas residents don't have health insurance, more than double the national average and the highest rate of any state. Krisberg and Leffler spent more than a year reporting on a group of medical professionals who opened a free medical clinic in rural East Texas in an effort to reach low-income residents who need health care the most. 

Texas is one of 12 states that haven't expanded Medicaid under the Patient Protection and Affordable Care Act, and Medicaid eligibility in Texas "is so restrictive that a family of three is denied coverage if it earns more than $4,000 a year," Krisberg and Leffler write. "Those who do qualify may not be able to find doctors who accept public insurance because the state’s reimbursement rates are so low. A 2017 survey found that a third of Texas doctors refuse to accept new Medicaid patients."  

In May 2020, when the free clinic opened in Gun Barrel City, a town of 6,400 where nearly 30% residents lack health insurance, it soon became fully booked, often serving patients who had been forced to delay treatment they could no longer afford, Krisberg and Leffler report: "One woman had postponed surgery for an abdominal tumor because she had lost her job and health insurance," and the doctors rarely had a week "without seeing someone who lived in a car." 

Securing constant, reliable funding for the clinic and others like it is a challenge, Krisberg and Leffler write. The clinics' doctors successfully lobbied for a state law that allowed free clinics to apply for a slice of federal Covid-19 relief money, but until state policy is able to expand coverage for uninsured Texans, the free clinic's work will be like "peeing in the ocean," said Dr. Doug Curran, one of the physicians who came out of retirement to start the clinic.