National Report Shows Lack of Health Insurance is a Problem Across Texas

We already know that Texas has the worst children’s uninsured rate in the nation, but a new report highlights how widespread the challenge is across Texas, jeopardizing children’s access to doctors, medications, immunizations, mental health treatment, therapy to address disabilities, and more.

Reading the report from the Georgetown University Center for Children and Families underscores that the high uninsured rate for kids is a statewide problem that requires statewide solutions from the Texas Legislature. The report also shows that the uninsured rate improved in 2022 thanks to pandemic-era Medicaid rules, but the unwinding of those policies — and termination of insurance for many children before their eligibility is determined — is erasing those gains.

The Census Bureau data used in the report shows that in 2022, Texas had a children’s uninsured rate of 10.9%, more than double the national rate of 5.1%. As we recently reported, Texans of all racial/ethnic backgrounds identified in the survey — Asian, White, Black, Hispanic, and American Indian — had higher uninsured rates than the national average, while significant racial/ethnic disparities are also a challenge.

The new report from Georgetown goes a step further in showing that Texas kids from all corners of Texas are affected. The report found that out of the top ten metro areas in the US with the highest kids’ uninsured rate, six of them are in Texas.


The report also shows that numerous Texas communities have uninsured rates over 10% (compared to the national rate of 5.1%), including Abilene, Beaumont, Brownsville, Dallas-Fort Worth, El Paso, Houston, Laredo, Longview, McAllen, Midland, Sherman, and Waco.


These communities have different demographics, economics, geography, and culture but one constant: They are subject to the health care policies determined by the Texas Legislature and Governor.

To address this challenge, state leaders should:

  • Invest the funding necessary to reduce delays in processing Medicaid applications for children and other Texans within the state’s narrow eligibility guidelines.

  • Improve the current Medicaid “unwinding” process to ensure that eligible Texans remain enrolled and Texans who are no longer eligible are transferred to other programs.

  • Approve bipartisan legislation by Reps. Bucy, Harless, Oliverson, Jetton, and Bonnen to use already-verified information to create an “Express Lane” option that facilitates health coverage enrollment for currently eligible kids. The bill passed the Texas House overwhelmingly in the 2023 session but did not receive a Senate hearing.

  • Ensure robust Medicaid outreach that addresses concerns of mixed-immigration status families, including families for one in four Texas kids. (Note that undocumented immigrants are NOT eligible for Medicaid.)

  • Ensure meaningful language access to Medicaid/CHIP by making applications, notices, and outreach materials available in multiple languages, not just English and sometimes Spanish. 

  • Implement Medicaid expansion, which will directly offer an affordable health insurance option to adults with jobs below the poverty line and indirectly reduce the children’s uninsured rate through the “welcome mat” effect.