Urban Review: The Power of Porches, Subsidized Healthcare and a 100-Day Agenda for Harris County

Title Page

On the Front Porch, Black Life in Full View. New York Times.

Introduction

'Public Charge' Changes Could Mean Fewer Children Receiving Medicaid And CHIP, Study Says. KUT.

“This could have a large effect because, in Texas, 31.5 percent of all Medicaid/CHIP-covered children were citizen children living with one or more noncitizen parents."

Executive Summary

Housing, transportation, health, education. It's all connected. But a new bit of research shows just how connected when it comes to housing and health. The study looked at the impact of Medicaid expansion and access to Obamacare. Because states were permitted to opt out of Medicaid expansion, the study authors were able to compare the financial outcomes of roughly similar populations depending on access to subsidized healthcare. The results were decisive. Poor people with access to subsidized healthcare were less likely to experience finance-related housing instability.

"Those who were able to acquire health insurance under Obamacare’s subsidized exchanges were 25 percent less likely to miss paying their rent or mortgage on time," summarizes CityLab writer Kriston Capps. "It’s the first study to link the healthcare exchanges (or Marketplaces) to financial well-being," according to Emily Gallagher, assistant professor of finance at the University of Colorado Boulder, who completed the study with researchers from Washington University in St. Louis and the Federal Reserve Bank of St. Louis.

"Instead of having roughly a one-in-three chance of being delinquent if you are uninsured and have an income near the poverty line, your chances look more like one in five,” Gallagher told CityLab.

Housing is just one of the ways access to healthcare has impacted households following the Affordable Care Act and, particularly for low-income households, health insurance appears to be "a powerful financial stabilizer" generally.

A number of states, including Texas and much of the south, did not expand Medicaid. And recent numbers show that the state has actually seen an increase in the number of uninsured children, so much so that Texas actually leads the nation, representing roughly 20 percent of the country's uninsured children.

With research like Gallagher's, it's becoming increasingly clear the consequences of not having access to insurance. This is something the public at large seems to grasp. A recent survey from the Texas Medical Center found that 60 percent of Texans supported expanding Medicaid. And as Capps points out, several red states voted to expand Medicaid in the 2017 midterm elections.

"I’m not sure it’s clear to certain politicians," Gallagher told Capps. "But if you look at the studies, it’s overwhelming.”

Conclusion

There was a significant shift in Harris County's elected leadership in the midterm elections as the region continued to shift blue. So what should be on the agenda of this new leadership? Texas Southern University assistant professor Jay Aiyer spells it out in a recent Houston Chronicle column outlining a potential 100-day agenda.

Flood mitigation tops the list, but Aiyer stresses that it should be done in a comprehensive way, integrating everything from affordable housing to toll road expansion into the conversation. Justice reform should also be high on the list, according to Aiyer, particularly after efforts to enact bail reform "had been stymied by Commissioner’s Court and the current roster of criminal judges." Improved voter registration and expanded early voting opportunities were also included, as well as early childcare initiatives.

"This election cycle," says Aiyer, "has given Harris County Democrats a unique opportunity to implement fundamental changes to county government."

Endnotes