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Thursday, May 14, 2020

Texas Workforce Commission pays $20 million in benefits to self-employed Texans, freelancers

Self-employed and Freelancers in Texas get $20 million in Pandemic Unemployment Assistance So, what does unemployment have to do with health and wellness? Almost everything, actually. People who do not have health care coverage have worse disease states and shorter life spans. By and large healthcare in America for able-bodied adults is employer-sponsored. It's a job-lock system. The mechanism to provide health care to the able-bodied outside of employment is severely restricted. Texas Medicaid rules strictly limit which adults can get health coverage, and most adults who can work are ineligible. Only those who get federal supplemental security income disability benefits can get Medicaid. Medicaid is for low-income adults, kids, people with disabilities and pregnant women. If you are an adult without children, you can't quailfy for medicaid in Texas, no matter how little you earn. Most Texas adults with serious and chronic illnesses do not qualify for Medicaid. Medicare is customarily for people age 65 and older. Although, you can qualify if you're under 65 and have a certain disability or a chronic illness such as End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). The ACA offered states the optional expansion of Medicaid to those at 138% of the federal poverty income level; however, Texas does not participate in this expansion. Subsidies for private insurance in the Marketplace ( are only available to people above the poverty level. Moreover, the Marketplace insurance products may not be well accepted by healthcare facilities. You may pay your monthly premiums, but this does not guarantee access to care. Coverage does not mean access. Essential workers commonly fall into such gaps. Public service workers, truckers, packers, stockers, food service workers, cashiers, self-employeds, freelancers, etc are afloat without a life vest. We need to move beyond a job-lock system of healthcare in America. Your healthcare should be portable. For security of self and your family, you should have access to affordable healthcare insurance, have healthcare insurance which is actually accepted where you live, and be able to take your preferred healthcare product with you job or not. Finally, your health care insurance should be accepted throughout the US. Just because you cross a state line does not void/restrict that coverage. Afterall, are we full Americans only if we get ill in Texas? Or, are we Americans deserving of full healthcare in whichever state we may succumb to illness?
from Rajesh Harrykissoon, MD

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