Census Data Show Tiny Gain in Texas Health Coverage, but Change in Census Survey Requires New Comparisons

On Tuesday, September 16, the U.S. Census Bureau released annual estimates on health insurance coverage based on the Current Population Survey (CPS) and the American Community Survey. To better understand the difference between the two surveys, view our side-by-side comparison. The new data released today are for 2013, and do not include the effects of the full implementation of the Affordable Care Act. Impact of the Affordable Care Act, such as the opening of the Health Insurance Marketplace and Medicaid and related coverage expansions, will be not reflected until next year’s data release in September 2015.

While the Current Population Survey includes detailed information about health insurance coverage and has been used to show decades-long trends in the past, changes in this year’s survey methodology mean that the 2013 CPS data cannot be compared to previous years. For year-to-year comparisons for Texas, the Census Bureau and the Center for Public Policy Priorities recommend using the American Community Survey (ACS) 1-year estimates. To encourage use of the ACS, which has reported health insurance estimates since 2008, the Census released limited state-level health insurance estimates from that survey today alongside the newly-revised CPS data report.

The Census Bureau will release the complete ACS data tables, including income and poverty, this Thursday, September 18.

Today’s health insurance data release shows:

  • Texas continues to have the highest uninsured percentage in the U.S. (22.1% of Texans of all ages uninsured when surveyed). (Nevada and Florida are the next in line.) (ACS)
  • Texans with health coverage saw a tiny, but statistically significant, increase from 2012 to 2013, of less than one-half of one percent. The pre-2014 provisions of the Affordable Care Act have worked to stabilize private and public health coverage. (ACS)
  • Texas has the largest number (604,000) of uninsured children with family incomes below twice the poverty line (200% of the federal poverty level: potentially eligible for Medicaid or CHIP), and is second only to Nevada in the percentage of low-income uninsured children. (ACS)
  • The ACS survey estimates 8.3% of low-income Texas children are uninsured, compared to 5.1% in California, and 2.3% in New York.
  • CPS estimates for Texas show children (ages 0 to 18) across the full income spectrum are only half as likely to be uninsured as working age adults 19 to 64. This is almost entirely due to the availability of Medicaid and CHIP coverage for Texas children, but the lack of any parallel public insurance for those children’s parents and other low-wage adults.
  • Texans remain far less likely to get covered through their own job, or a spouse or a parent’s job, than the average American. (57.1% of Americans versus 50.7% of Texans). Only Arkansas, Florida, New Mexico, and Mississippi have lower rates of employer-sponsored insurance. (CPS)
  • The weakness of Texas’ employer-sponsored coverage has been a big factor in Texas’ last-place uninsured rate ranking, and creates a substantial demand for the new health insurance Marketplace where individuals and families can buy coverage with sliding-scale premium assistance.

CPPP will provide further analysis after the Census releases detailed poverty and income data on September 18. For more details please contact [email protected]

Written by Anne Dunkelberg, Center for Public Policy Priorities. Cross-posted from Better Texas blog.