Health

The cost of staying well

Texas chose not to expand Medicaid. That single decision left over a million Texans without coverage. In Houston, the safety net exists but knowing how to access it is half the battle.

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1M+

Texans in the Medicaid gap

$420

Monthly healthcare cost, uninsured

38%

Houstonians speak Spanish at home

Houston Public Library branches

The Gold Card program covers doctor visits, hospital care, and prescriptions for uninsured, low-income Harris County residents. Most people who can access it do not know it exists.

Texas is one of ten states that chose not to expand Medicaid under the ACA. That is not a budget reality. It is a policy choice made by the state legislature. The result: over a million Texans earn too much for traditional Medicaid but too little for marketplace subsidies. They fall into a coverage gap that does not exist in expansion states.

In Harris County, the safety net is real but complex. Harris Health System runs Ben Taub and LBJ hospitals plus a network of community clinics. The Gold Card program covers doctor visits, hospital care, and prescriptions for uninsured, low-income residents. It is not perfect, but it is real. Most people who can access it do not know it exists.

Mental health is where the gap hits hardest. MHMRA of Harris County serves people in crisis, but wait times for non-emergency care stretch weeks. School counselor ratios in HISD exceed 400:1 in some buildings. The 988 Suicide and Crisis Lifeline works nationally, but local follow-up capacity determines whether a call leads to care or a dead end.

Environmental health is the invisible layer. Houston has more petrochemical infrastructure than almost any U.S. metro. Air quality complaints go to TCEQ, but enforcement is slow and industry-friendly. Communities near the Ship Channel breathe different air than communities in River Oaks. That is not geography. That is zoning.

RESOURCES & OPPORTUNITIES

In health right now

Harris County resolution tracker

Racism and sexism declared a public health crisis — June 23, 2020 · Track progress on 5 metrics

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From the learning center

Read, watch, understand.

articleMar 30

How the Gates Foundation Helps Kids Around the World Stay Healthy

The Gates Foundation works to help every child reach their full potential, no matter where they are born. Each year, nearly 5 million children die before age 5, mostly from preventable causes like malnutrition and diseases. Kids in poor countries are 80 times more likely to die young than those in wealthy countries. The Foundation focuses on three main areas: helping mothers stay healthy during pregnancy and childbirth, fighting diseases through vaccines and good nutrition, and creating economic opportunities so families can escape poverty. They support new medical tools like portable ultrasound machines and simple devices that help doctors spot dangerous bleeding after birth. Vaccines have saved 146 million children's lives since 1974. The Foundation helped create Gavi, which has reached 1.2 billion kids with vaccines. They also support farmers who grow food for billions of people and work on education programs. Since 1990, extreme poverty has dropped from 40% to 10% of the world's population. The Foundation believes that when children are healthy and educated, they can improve their communities and create a better future for everyone.

articleMar 30

ACA Health Insurance Research and Policy Analysis

The Center on Health Insurance Reforms at Georgetown University studies how the Affordable Care Act (ACA) affects health insurance. The ACA created health insurance marketplaces where people can buy affordable health plans with help paying for them. The center's experts research how well these policies work and suggest improvements. They write reports and blog posts about health insurance costs, coverage options, and policy changes. Their work helps policymakers understand what's working and what needs fixing in health insurance. They focus on making sure people can get affordable, quality health coverage. The center tracks enrollment numbers, premium costs, and how policy changes affect consumers. They also study small business health insurance challenges and state-level policy responses. Their research helps inform decisions about health insurance policy at federal and state levels.

articleMar 30

Better Healthcare Through Tech That Helps Patients Know Their Options

McKesson, a major healthcare company, wants to use technology to help patients make better healthcare decisions. Right now, many healthcare systems don't share information well with each other, making it hard for patients to know what treatments cost or what their insurance covers. When patients don't take their medicines as prescribed, it causes 125,000 deaths each year and costs $100 billion. McKesson believes that if patients could easily see their insurance benefits, medication costs, and coverage details in real-time when they visit the doctor or pharmacy, they would be more likely to take their medicines correctly. They want states to require health plans and pharmacy benefit managers to provide this cost and benefit information instantly at the point of care. This would help patients make informed choices about their healthcare and lead to better health outcomes.

articleMar 30

Hillcrest Foundation Helps Seniors with Special Gifts and Care

The Hillcrest Foundation helps older adults in Nebraska by giving them special gifts that make their lives better. They provide things like lift chairs to help people get up safely, wheelchair ramps for easier home access, magnifying lights for reading, and even special celebrations like weddings and anniversaries. Each gift is chosen based on what each person really needs or wants. The foundation works with caregivers, family members, and the seniors themselves to understand what would help most. They have helped people celebrate final holidays with family, get mobility aids after strokes, and even arranged a wedding for a hospice patient. Their goal is to make sure every older adult feels valued and supported. While this organization serves the Omaha and Lincoln areas in Nebraska, it shows the kind of senior support services that communities need everywhere.

articleMar 30

McKesson Fights for Safer Health Technology Rules

McKesson is a healthcare company that wants to change how the government regulates health technology. They believe current rules for health IT are outdated and based on laws from 40+ years ago. Health information technology helps doctors avoid medical mistakes and provides better care at lower costs. McKesson wants new rules that focus on risk levels - treating high-risk technology differently from low-risk technology. They have been working with Congress and government agencies since 2012 to create smarter regulations. The company has testified before Congress multiple times and submitted detailed comments to federal agencies. They support specific bills like the SOFTWARE Act and PROTECT Act that would create better oversight for health technology. McKesson argues that health IT should be regulated differently from traditional medical devices because they work differently. Their goal is to protect patient safety while still allowing innovation in healthcare technology. The company provides detailed documentation including congressional testimony, letters to lawmakers, and regulatory comments showing their advocacy efforts. This represents a major corporate effort to influence healthcare policy at the federal level.

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Policy landscape

The laws that shape this.

StateMedicaid expansion

−$420/mo for uninsuredBlocked by legislature

CountyGold Card enrollment

+$0 primary careOpen enrollment

CountyMHMRA funding

Wait times for mental healthBudget cycle

StateTCEQ air permits

Ship Channel air qualityOngoing approvals

FederalACA marketplace subsidies

−$200–400/mo premiumsActive

StateSchool counselor ratios

400:1 in some HISD schoolsTEA standards

Active fights right now

Medicaid expansionBlocked

TX legislature has blocked expansion since 2013. Over 1M Texans in coverage gap.

TCEQ permitting reformActive

Communities near Ship Channel pushing for stricter air quality enforcement.

Active health policies tracked

Government levels involved

Cost of Gold Card enrollment

988

Crisis line, available 24/7

What you can do

Start here, right now.

5-minute actions

5 minutes

Check Gold Card access

If you are uninsured in Harris County, the Gold Card covers primary care, hospital visits, and prescriptions at no cost. See if you can access it at Harris Health.

Do this now ↗5 minutes

File a TCEQ air quality complaint

If you smell chemical odors or see emissions, call 1-888-777-3186. Every complaint creates a legal record.

Do this now ↗5 minutes

Call your state rep about Medicaid

Texas is one of 10 states that chose not to expand Medicaid. Your state representative votes on this. Call them.

Do this now →

Deeper engagement

1–2 hours

Attend a Harris County Public Health meeting

Environmental health investigations start with community input. Meetings are open to all residents.

Get involved ↗1–2 hours