Posted on May 17, 2010

Williamson County to Stop Footing Health Care Bills of ID-Less Indigent People

Claire Osborn, Statesman, May 9, 2010

Williamson County commissioners have decided to stop paying health care costs for indigent adults and children who don’t have valid Social Security cards.

County Judge Dan A. Gattis said last week that he wanted to ensure that there was enough money for the residents of Williamson County who qualified for indigent care to remain covered. In the first five months of the current fiscal year, 265 people who didn’t have Social Security cards received county-paid health care out of a total of 1,153 indigent patients, said Bride Roberts, the coordinator for Williamson County’s indigent health care system.

The decision–which came in a unanimous vote on April 27–was not based on race, Gattis said.

“We are running out of money,” he said.

The county is required by the state to pay up to 8 percent of its general tax revenue annually for indigent health care, which is $7.1 million this fiscal year, Roberts said.


The county’s indigent health care expenses have risen from $1 million in fiscal year 2000 to $5.4 million in fiscal year 2009, according to county records. The expense is projected to reach $9.4 million in the current fiscal year, Roberts said, which would equal 10.5 percent of the general tax revenue budget.

Roberts said there were several reasons for the increased expense, including a large number of “very sick” people and new hospitals in the area identifying more people who may qualify for the program.

Williamson County residents without legal Social Security cards can still get care at four clinics in Georgetown, 10 clinics in Round Rock and one in Granger, all operated by Lone Star Circle of Care, a nonprofit community health organization, said Rebekah Haynes, the group’s communications director.

Roberts said patients without valid Social Security cards accounted for 12 percent of the $3.7 million spent under the program in the first five months of the fiscal year. During fiscal year 2009, 1,505 people were covered, and 331 of those didn’t have valid Social Security cards, she said.

The county estimated that it can save $1 million a year by denying coverage to people without legal Social Security cards, Roberts said.


“Virtually all counties do include undocumented residents in their county indigent health care programs,” said Dunkelberg [Anne Dunkelberg, the associate director of the Center for Public Policy Priorities in Austin], who called the county’s decision “a bad idea.”

“Making sure you are providing good access to prenatal care is extremely important because all babies are U.S. citizens,” she said.


The county’s indigent health care program covers up to $30,000 per year in costs for doctors, hospitals, clinics, lab work, prescriptions and diagnostic testing for people with incomes equal to 21 percent or less of the federal poverty level, which works out to a monthly income of $190 or less for a single person, Roberts said.