Closing Keynote: Every Texan’s Luis Figueroa and Sen. Nathan Johnson discuss access to healthcare coverage


Maddie McCarthy, Alex Nelson


Texas Sen. Nathan Johnson (D-Dallas) and Luis Figueroa, chief of legislative affairs at Every Texan, sat down to discuss the status of healthcare coverage in the state at the 2024 Texas State of Reform Health Policy Conference on Feb. 27.

Johnson said reforming healthcare systems would ultimately save the state money, but reform will take time. However, there are immediate actions people can take to find affordable healthcare coverage, Johnson said. One option is the use of Affordable Care Act (ACA) federal subsidies.

“People don’t know that they qualify for federal subsidies. They don’t know how to apply for them. They can’t get through the interface. There are some fairly easy fixes, logistically easy fixes—and then we get to the political part—that will make healthcare more affordable merely because we have subsidies that help people pay for access to insurance. And that’s just before we even get to reforming the healthcare system in general.”

— Johnson

Figueroa said the state has seen many people sign up for ACA health insurance plans because of its subsidies. 

“We are in a boom under the ACA marketplace largely because of federal subsidies. We’re covering about 2.4 million Texans and people are able to get access at $10 or less a month in some cases. This has been a huge boom for Texas and a very successful, new, emerging access point for coverage.”

— Figueroa

Even though more Texans have enrolled in ACA health plans, Figueroa is concerned about the impact of the Medicaid unwinding. He said the unwinding has had a particularly devastating effect on Latino families, as well as all families who rely on Medicaid access for their children. 

“We’re going to have to start repairing some of that damage in the next session. I hope we can start talking about processes to remove some of those barriers to get people back on the rolls in an expedited process, and I’m hoping those conversations will have some real meaning next session in light of the unwinding.”

— Figueroa

Johnson said the effort to improve the state’s healthcare system is bipartisan, and he believes it is slowly moving toward larger reforms.

“What I’d love to see the legislature finally do is pass a health literacy bill … When people don’t understand the system they can’t access it and it generally leads to poorer health outcomes and higher costs. But I think maybe the opposition is fading as we run out of quick fixes to fix our healthcare system. I think people are starting to realize that the healthcare space is necessarily an intersection of individual needs, advocates, industry, and government.”

— Johnson

Both Johnson and Figueroa said they support the expansion of Medicaid, as Texas is one of 10 states that has not done so.

“There is bipartisan support [for expansion]. It polls well, over 70 percent across Texas. Rural hospitals are in desperate need of it. All the things are there for us to do it, [but] we just can’t get past that political threshold and it just doesn’t make sense policy-wise why we haven’t gotten there.”

— Figueroa

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