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People in Texas, Florida more likely to have medical bills

People in Texas, Florida more likely to have medical bills
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A new study finds people are significantly more likely to put off care and have trouble paying medical bills in Texas and Florida, which have not expanded Medicaid under ObamaCare. 

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The study from the Commonwealth Fund, a health research organization, uses survey data to compare the four largest states: California, New York, Texas and Florida. It finds higher access to healthcare in California and New York, which have expanded Medicaid. 

The uninsured rate is 12 percent in New York and 17 percent in California, compared to 21 percent in Florida and 30 percent in Texas, it finds. 

In New York and California, 18 percent of people had a medical problem but did not visit a doctor because of cost constraints. In Florida and Texas, the rate is higher, at 29 percent and 26 percent, respectively.

Likewise, in New York and California, 11 percent and 9 percent of people, respectively, were contacted by a collection agency about medical bills. In contrast, in Florida and Texas, the rate is 17 percent and 21 percent. 

The study notes that the differences are not entirely due to the decision on Medicaid, the government health insurance program for the poor. 

For example, there are demographic factors like a higher rate of people in the country illegally, who are ineligible under the health law, in Texas. But even when accounting for demographic factors, there is a contrast. 

Florida Gov. Rick Scott (R) had for a time supported Medicaid expansion but reversed his position this week, citing distrust of the federal government. He pointed to a showdown with the Obama administration over proposed cuts to a separate pool of federal money for hospitals that serve low-income patients. 

For a time, there was speculation that Texas Gov. Greg Abbott (R) was open to expansion, but he has since rejected the idea. 

The threshold for eligibility for Medicaid is much lower in Texas and Florida. 

In Florida, parents of dependent children making less than 34 percent of the poverty level, meaning about $8,000 for a family four, are eligible for the program. In Texas, the eligibility is even lower, at about $4,475 for a family of four.  In both states, childless adults are not eligible. 

In states, such as New York and California, that expand the program under ObamaCare, eligibility is up to 138 percent of the poverty level, meaning about $32,000 for a family of four. 

In an interview with ABC this week, President Obama urged states to expand Medicaid. So far, 28 have, including some Republican states that have negotiated with the administration to allow conservative twists like beneficiaries paying premiums.

Other Republicans are concerned about the cost of the program and object to the Affordable Care Act as a whole. 

“There are millions more people that could be helped, and it won't cost the state anything," Obama said. "We're just seeing some stubbornness that's really based on ideology not on wise public health policy that is preventing most people in most states from getting the Medicaid that would save the state money in the long term.”