Health care is high on the ballot in Texas, the uninsured capital of the United States

Texas border towns are among the most uninsured pockets of the United States, where as many as one in four people lack health coverage — and cannot afford it under the current system.

Meanwhile, the Lone Star state is the uninsured capital of the country with 17.3 per cent of its residents lacking health care insurance, compared to a national uninsured average of 8.7 per cent, according to the latest data provided by the US Census Bureau.

The issue has found its way to the core of the 2018 midterm elections, threatening to unseat the state’s local leadership with a swath of progressive candidates vowing major reforms if elected in November. A Democrat has not been elected to statewide office since 1994.

“My mom is a resident alien currently, so it’s a strong issue in my family,” Haley Smith, a San Antonio resident, tells The Independent about why she is voting in November. “But I’m also really concerned about our state’s health care issue, as I’m a nurse, and it’s very, very important to me that all people can have access.”

Nearly two-thirds (61 per cent) of Texas voters said they will likely only support a candidate who promises to make fixing health care a priority, according to the Texas Medical Centre’s fourth annual national consumer survey, released in September.

The centre surveyed over 1,000 voters across the state, as well as more than 5,000 people across the country, for its report titled “The Nation’s Pulse”.

Expanding Medicaid has widespread support on both sides of the aisle in Texas, according to the survey, which shows at least 60 per cent of voters favour broadening the health care programme.

That support a joint Kaiser Family Foundation and Episcopal Health Foundation survey published in June, which found 64 per cent of Texas support a Medicaid expansion.

Beto O’Rourke, the state’s Democratic candidate for US Senate, has made expanding health care coverage a central focus of his historic campaign, which is within spitting distance of unseating Republican incumbent Ted Cruz.

“The overriding concern throughout Texas, big cities and small towns alike, Republicans and Democrats, is our ability to be well enough to do the things we’re intended to do in our lives,” he said at a recent rally.

The issue has also paved the way for Congressional candidates like Gina Ortiz Jones, who is seeking to unseat Republican incumbent Will Hurd in the state’s 23rd district, to have an unprecedented shot at victory in the upcoming elections.

In a recent interview with The Independent, Ms Jones — who would become the first Iraq war veteran, first out lesbian and first Filipina from Texas to serve in Congress if elected — explained the need to combat increasing drug prices and how she would bring access to highly uninsured border towns like Alpine, Texas, which is included in her congressional district.

“Medicare should be negotiating prescription drug prices – that’s something we can work on right out of the gate.” she said. “There are 11 community health clinics in this district; and one in Crystal City has had an opening for a full-time position for three years … These are medically underserved communities, financially underserved as well, educationally underserved, and I think looking at ways in which we can incentivise medical professionals to work in our rural areas is good for all of us.”

She added, “We should also invest in the infrastructure of broadband, which helps make something like telemedicine and telepsychiatry a reality.”

Under Donald Trump, the US federal government has made massive cuts towards outreach spending to get people registered under the Affordable Care Act, otherwise known as Obamacare. That caused areas like Alpine and other border towns to see a major decline in new registrations annually.

Meanwhile, many border towns across Texas are low-income communities that are unable to afford health care. Without a public coverage option, those Texas voters who do not qualify for Medicaid and cannot afford insurance are currently left without any options.

Whether that changes the electoral map in November remains to be seen, however, one thing can be clear – the health care issue does not seem to be going anywhere in Texas after the 2018 midterms.