Report: Rising Uninsured Rate for Texas Kids

For Immediate Release
Contact: Peter Clark, [email protected], 512-473-2274

Texas Has The Worst Rate of Uninsured Children in the US

AUSTIN - Texas saw one of the nation’s worst increases in the children’s uninsured rate last year, with the state’s rate rising from 9.8 percent in 2016 to 10.7 percent in 2017, according to a new report released by the Georgetown University Center for Children and Families. The report shows that Texas has by far the worst uninsured rate for children in the nation, followed by Alaska’s rate of 9.6 percent. Previous reports have shown that the Texas uninsured rate for adults is also the highest in the nation.


The new report also found that the number of uninsured children nationwide increased from 4.7 percent in 2016 to 5 percent in 2017, the first significant increase in a decade. In 2017, an estimated 3.9 million children were uninsured nationwide, an increase of 276,000 from 2016. The increase occurred in the midst of the administration and Congress taking several steps to undermine health care.

“This increase in the child uninsured rate, particularly in states that did not expand Medicaid, is a warning sign to policymakers,” said Joan Alker, executive director of the Georgetown University research center and lead author of the report. “Barring new and serious efforts to get back on track, there is every reason to believe the decline in children’s coverage is likely to continue and may get worse.”

The report shows that in 2017, an estimated 835,000 Texas children were uninsured, an increase of 83,000 from the prior year. The uninsured rate increased for Texas kids of all income levels and race and ethnicities and among children with Medicaid/CHIP insurance as well as those with insurance purchased directly in the individual market. Texas has the largest share of children without health coverage in the country, with more than one in five uninsured U.S. children residing in the state.

“This is a disturbing report for anyone who wants Texas kids to get the eyeglasses they need to read the chalkboard at school, mental health treatment they need to be healthy, early treatment to stop cancer before it spreads, and everything else that health insurance can mean for a child,” said Adriana Kohler, Senior Health Policy Associate at Texans Care for Children. “Texas leaders need to make a commitment to reducing the state’s sky-high uninsured rate for kids and adults.”

Texans Care for Children is a member of the Cover Texas Now coalition that released the report in collaboration with the Georgetown University Center for Children and Families.

The Cover Texas Now coalition’s 2019 policy agenda includes several recommendations that would reduce the children’s uninsured rate in Texas. The coalition is urging state legislators to allow Texas children to remain in the Medicaid health insurance program for a full year — like Texas does for children in CHIP insurance. Texas Medicaid rolled back eligibility rules for children in 2014. Now, children may be subject to providing paperwork and possibly losing coverage at several points during the year. To reduce the uninsured rate for Texas children and adults, Cover Texas Now is also urging state leaders to expand Medicaid to cover uninsured low-wage adults or to develop an alternative Texas strategy to cover low-wage adults.

The experience in other states has shown that when parents gain health coverage, their children are more likely to have coverage as well. Three-quarters of the children who lost coverage nationwide between 2016 and 2017 live in states such as Texas that have not accepted the Medicaid expansion funding offered by the federal government to cover uninsured low-wage workers. In Texas, the kids’ uninsured rate increased at more than quadruple the rate of Medicaid expansion states.

“When the Legislature decides to provide a health coverage option to uninsured construction workers, child care teachers, and other low-wage Texas adults, we know that it will help many of those moms and dads provide health coverage for their children,” said Ms. Kohler.

Many uninsured children are eligible for insurance through Medicaid, CHIP, or, but parents are often unaware of the programs or how to sign up. The deadline to enroll in insurance for 2019 through is just a few weeks away on December 15th. Local organizations in communities throughout Texas are offering families assistance with the enrollment process.

This is the eighth annual report on uninsured children published by the Georgetown University Center for Children and Families, an independent, nonpartisan policy and research center founded in 2005 with a mission to expand and improve high-quality, affordable coverage for America’s children and families. The Georgetown University Center for Children and Families is based at the McCourt School of Public Policy.