The executive commissioner of Texas’ Health and Human Services Department, Texas’ “health czar” if you like, thinks the high rate of uninsured people in the state is a myth. he thinks Texans may not have health insurance because the weather’s too nice, or something. No really.
Kyle Janek doesn’t believe—despite credible, widely accepted evidence to the contrary—that one of Texas’ most pressing health problems, its high number of uninsured adults, is real. He doesn’t believe that more than a quarter of Texans are uninsured, as estimated by the U.S. Census Bureau. He told a Texas Tribune reporter in early October that he believed that number to be “inflated,” and then reiterated his point in an extended interview with Tribune editor Evan Smith on October 31st. (Through his press representatives, he refused an interview with RH Reality Check.) Here’s his most recent take via the Tribune:
“It’s not that I don’t believe those numbers. I don’t believe the reasoning for those numbers.”
Janek’s problem: he said the Census Bureau only takes a “snapshot” by asking people if they’re uninsured, and doesn’t ask them if they had insurance in the past or if they think they have a job lined up with insurance in the future. Janek must not be aware that for nearly 25 years, the Census Bureau’s “snapshot” has shown practically the same thing: since 1987, Texas repeatedly has one of the highest, or the very highest, number of uninsured adults in the country. That rate has not been below 1987’s 23 percent; it peaked at 26.8 percent in 2009 and is currently estimated at 26.2 percent.
That’s a remarkably consistent snapshot of something that Janek seems to believe changes for millions of people by the day. Janek says he isn’t sure why Texas “is different” when it comes to health care, but he told the Tribune it could be because the weather here is nice.
“Do we have so many people that are temporarily uninsured? Or is it the general climate of better weather and glorious place to live? Folks come here, and that attracts more folks with health care needs or disabilities?” he wondered during the interview. Surely our high uninsured numbers couldn’t be due to the fact that Texas jobs generally don’t provide health insurance, that Medicaid in the state is limited, that insurance rates are unregulated or that Texas has a large immigrant population, as the Washington Post reported last year. No, it’s probably just the purty weather.
I called Dr. John Holcomb, a pulmonologist who chairs the Texas Medical Association’s committee on Medicaid, to find out what he makes of Janek’s stance. (Spoiler alert: the TMA’s official position is that “Texas is the uninsured capital of the United States.”) Holcomb told me that Janek’s comments are “a perfect example of how Dr. Janek is not ready for prime time.”
The saddest thing about this is that Janek will keep repeating this nonsense, it’ll get picked up and amplified as a serious possibility by the right wing noise machine, and pretty soon a third of Americans will believe it like they believe “theory” means something is optional (try telling the theory of gravity that as you step off a tall building).