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Analyzing Texas Healthcare Insurance Policy on Immigrants Using the Bardach Model
By (Student name)
Institutional Affiliation (School)
Course Title & Code
Instructor/Tutor
Date
, 2
Analyzing Texas Healthcare Insurance Policy on Immigrants Using the Bardach Model
Introduction
Easy and equal access to healthcare is a human right enshrined in the United States,
specifically in Article 25 of the Universal Declaration of Human Rights (UDHR), which
recognizes healthcare as a pertinent part of the standard of living and well-being. It also includes
the “right to security in the event of sickness [and] disability” (Jost, n.d.). The right is also
protected in Article 12 of the International Covenant on Economic, Social and Cultural Rights
(ICESCR) of 1966, which considers access to medical care as elementary to dignified living.
However, amid fights for averting socioeconomic and political injustices, the US has seen the
perennial crop of laws and policies that coin disadvantages and exclusion from benefits for
minority groups. An example is the five-year-bar, a healthcare policy that seeks to disqualify
immigrants from accessing healthcare insurance, not excluding the Child Health Insurance
Program (CHIP) and Medicaid (CMS, 2024). This paper analyzes this policy as it applies in the
state of Texas, using the first six stages of the Bardach model of analysis.
Stage 1: Defining the problem
Texas is one of the states in America reporting the highest rates of medically uninsured
populations. According to the 2022 census data, 4.9 Texans (of all ages), or 17%, were reported
to be uninsured, marking it the state with the largest uninsured population in the United States.
This was an increase of 700,000 from 2021 (Taylor-Ross, 2023; Melhado, 2023). Of this, KFF
(2024) observes that 20% is constituted of undocumented immigrants. According to TX 2036
(2023), documented or undocumented immigrants face a complexity of issues that create
bottlenecks that throttle their ability to enrol for health insurance coverage. These factors include
lack of required documentation, unemployment status, having a job that does not support health
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insurance, the complexity of the enrollment procedures, and factors (e.g., the 5-year bar policy)
associated with sustaining disqualification for immigrants. The chart below outlines primary
issues associated with high rates of medical coverage in Texas.
The disturbing fact is that, despite the challenges facing immigrants, their population is
rising drastically in Texas. In fact, data illustrates that Texas is ranked second among states
hosting the largest proportion of immigrants in the US (appendix 1). The total population of
Immigrants in Texas in 2018 was 4.9 million (American Immigration Counsel, 2020), rising to
5.1 million, or 17% of the Texas population in 2022 (Migration Policy Institute, 2023). In 2023,
the population of immigrants has risen again to 5.46 million, a rise by 24.94% from 2013
(USAFacts, 2024). According to Moslimani and Passel (2024), this ranked Texas second largest
host of immigrant population in the US after California.
Scope and Impact:
Low levels of health insurance access among Texans are associated with a variety of
adversities, mainly occurring in terms of poor health outcomes for the immigrants and the
entirety of residents. For example, lack of health insurance cover is a key determinant to poor
healthcare-seeking behaviors among people. Taylor-Ross (2023) found that 65% of uninsured
Texan adults were likely to postpone a healthcare appointment due to costs. The high uninsured
rates have also been associated with damaging effects on the Texas economy. A study by Grubbs
and Wright (2020) established that lack of health insurance increases rates of absenteeism at
workplaces and death rates of the productive population, poaching the state a huge chunk of
revenues via uncompensated health care. With the rise in the immigrant population anticipated in
the future, the study found that a lack of change in policy could sink the state in huge healthcare-
Analyzing Texas Healthcare Insurance Policy on Immigrants Using the Bardach Model
By (Student name)
Institutional Affiliation (School)
Course Title & Code
Instructor/Tutor
Date
, 2
Analyzing Texas Healthcare Insurance Policy on Immigrants Using the Bardach Model
Introduction
Easy and equal access to healthcare is a human right enshrined in the United States,
specifically in Article 25 of the Universal Declaration of Human Rights (UDHR), which
recognizes healthcare as a pertinent part of the standard of living and well-being. It also includes
the “right to security in the event of sickness [and] disability” (Jost, n.d.). The right is also
protected in Article 12 of the International Covenant on Economic, Social and Cultural Rights
(ICESCR) of 1966, which considers access to medical care as elementary to dignified living.
However, amid fights for averting socioeconomic and political injustices, the US has seen the
perennial crop of laws and policies that coin disadvantages and exclusion from benefits for
minority groups. An example is the five-year-bar, a healthcare policy that seeks to disqualify
immigrants from accessing healthcare insurance, not excluding the Child Health Insurance
Program (CHIP) and Medicaid (CMS, 2024). This paper analyzes this policy as it applies in the
state of Texas, using the first six stages of the Bardach model of analysis.
Stage 1: Defining the problem
Texas is one of the states in America reporting the highest rates of medically uninsured
populations. According to the 2022 census data, 4.9 Texans (of all ages), or 17%, were reported
to be uninsured, marking it the state with the largest uninsured population in the United States.
This was an increase of 700,000 from 2021 (Taylor-Ross, 2023; Melhado, 2023). Of this, KFF
(2024) observes that 20% is constituted of undocumented immigrants. According to TX 2036
(2023), documented or undocumented immigrants face a complexity of issues that create
bottlenecks that throttle their ability to enrol for health insurance coverage. These factors include
lack of required documentation, unemployment status, having a job that does not support health
, 3
insurance, the complexity of the enrollment procedures, and factors (e.g., the 5-year bar policy)
associated with sustaining disqualification for immigrants. The chart below outlines primary
issues associated with high rates of medical coverage in Texas.
The disturbing fact is that, despite the challenges facing immigrants, their population is
rising drastically in Texas. In fact, data illustrates that Texas is ranked second among states
hosting the largest proportion of immigrants in the US (appendix 1). The total population of
Immigrants in Texas in 2018 was 4.9 million (American Immigration Counsel, 2020), rising to
5.1 million, or 17% of the Texas population in 2022 (Migration Policy Institute, 2023). In 2023,
the population of immigrants has risen again to 5.46 million, a rise by 24.94% from 2013
(USAFacts, 2024). According to Moslimani and Passel (2024), this ranked Texas second largest
host of immigrant population in the US after California.
Scope and Impact:
Low levels of health insurance access among Texans are associated with a variety of
adversities, mainly occurring in terms of poor health outcomes for the immigrants and the
entirety of residents. For example, lack of health insurance cover is a key determinant to poor
healthcare-seeking behaviors among people. Taylor-Ross (2023) found that 65% of uninsured
Texan adults were likely to postpone a healthcare appointment due to costs. The high uninsured
rates have also been associated with damaging effects on the Texas economy. A study by Grubbs
and Wright (2020) established that lack of health insurance increases rates of absenteeism at
workplaces and death rates of the productive population, poaching the state a huge chunk of
revenues via uncompensated health care. With the rise in the immigrant population anticipated in
the future, the study found that a lack of change in policy could sink the state in huge healthcare-
