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More Texans enrolling in ACA, many don't know they're insured

A new federal report shows a 37% increase in Texans registering for the Affordable Care Act, but local clinics say many patients come to the clinic not knowing they have insurance.
Posted at 1:14 PM, Jan 26, 2024
and last updated 2024-01-26 14:14:23-05

BRYAN, Texas — Texas has the largest number of uninsured residents in the nation. According to a recent federal report, 2024 shows a 37% increase in Texans registering for government subsidized healthcare through the Affordable Care Act.

  • A local clinic director says many patients come to the clinic thinking they're uninsured when in reality they have been registered for ACA.
  • This can happen when people sign up for other benefits and simply check a box for health insurance but are not given any follow-up instructions.
  • In Texas, more than 1 in 9 residents are insured with ACA.


If everything is bigger in Texas, unfortunately that also means the number of uninsured residents. That's why a 37% increase in people enrolled for government subsidized Affordable Care Act is big news—but it's not all good news.

"The issue that we have seen, particularly with the ACA is that once our patients have signed up for it, and frequently Currently, there's been a huge push to get people signed up for it, but not enough information explaining the process and the details to patients."

Liz Dickey is the executive director at Health for All in Bryan, a free clinic for those who are uninsured.

Dickey says over the last 3-4 months, they've seen about a 50% increase in patients with ACA, but many come to the clinic not knowing they're enrolled.

"Does that mean there's people walking around who probably have ACA but don't know it? Yes. Yes, there are"

So, how does this happen?

"When you're applying for other benefits or other programs. They're adding it as kind of an add-on but without the full picture of what it is."

Dickey says while they prefer that everyone be insured, it's important that people are educated about their insurance plans.

"They suddenly have insurance but they don't know what that means. They don't know what their actual coverage or what their premium or deductible or any of the pieces that are really important to your budget and your life and how you're going to actually utilize it."