New Census Data: Texas Has Worst Uninsured Rate in US
For Immediate Release
September 12, 2024
Contact: Peter Clark, [email protected]
Advocates Call on State Leaders to Prioritize Health Coverage in 2025 Legislative Session
Austin - New data released today by the U.S. Census Bureau show that Texas has the worst uninsured rate in the nation for adults and children, prompting health care advocates to urge state leaders to prioritize the issue during the 2025 legislative session.
The new American Community Survey (ACS) data from the Census Bureau reveal that 21.7% of Texas adults age 19 to 64 went without health insurance in 2023, the worst rate in the nation. The Texas rate was almost double the national rate of 11.0%. Texas had a much higher uninsured rate than nearby states, including Arizona (13.5%), Arkansas (12.4%), Louisiana (10.0%), New Mexico (13.3%), and Oklahoma (16.1%). All of those nearby states have passed Medicaid expansion, but the Texas Legislature continues to block expansion in our state.
The Census Bureau report also shows that children in Texas were much more likely to go without health insurance than kids in any other state in 2023. The Texas uninsured rate for children was 11.9%, more than twice the national rate of 5.4%. Similar to health coverage rates for adults, the data show that the children’s uninsured rate in Texas was much worse than the rate in nearby states such as as Arizona (8.6%), Arkansas (6.7%), Louisiana (4.3%), New Mexico (5.9%), and Oklahoma (7.5%.)
“We’re deeply concerned that so many Texas kids are missing out on the health insurance they need for reliable access to health care,” said Diana Forester, Director of Health Policy at Texans Care for Children, a member of the Cover Texas Now coalition. “If state leaders want to make sure that kids can go to check ups, head back to school quickly when they’re out sick, and get other critical health care, then they need to make children’s health insurance a priority during the next legislative session.”
“Children’s health coverage is a vital part of much of the legislative agenda moving into 2025 — it impacts access to children’s mental health care, cancer and chronic disease prevention, and our overall health care spending as a state,” said Erin O’Malley, Senior Policy Analyst at Every Texan, a member of the Cover Texas Now Coalition. “Many of these priorities simply cannot be successful without access to care through access to coverage.”
“Part of what is so deeply troubling about our state’s soaring uninsured rate is that it doesn’t have to be this way. It is directly tied to our Governor’s and legislature’s refusal to expand Medicaid,” said Trudy Taylor Smith, Senior Administrator of Policy and Advocacy at Children’s Defense Fund - Texas, a member of the Cover Texas Now coalition. “This decision continues to put lives at risk across the state by depriving Texans from all communities, but especially communities of color, of access to medical care. Blocking Medicaid expansion has hurt all Texans — insured or not — by leaving millions of federal dollars on the table that could be helping to fund healthcare in our state.”
Advocates highlighted three strategies that are particularly important to reducing the uninsured rate in Texas:
The Legislature should improve access to health insurance for children who are eligible for coverage but unenrolled. About half of Texas children who are uninsured are eligible for insurance through Medicaid or CHIP. Steps policymakers can take to address this challenge include:
Reducing the backlog of Texas Medicaid applications by investing in upgrading the technology for the state’s eligibility and enrollment system.
When families apply for SNAP nutrition assistance, notify parents if their children turn out to be eligible for Medicaid health insurance as well. The Texas House passed a similar bill during the 2023 legislative session, but it did not come up for a vote in the Texas Senate.
Improve language access and Medicaid outreach that addresses concerns of mixed-immigration status families. One in four Texas kids lives in a mixed-status household. (Note that undocumented immigrants are NOT eligible for Medicaid.)
Address disruptions in Medicaid coverage for newborn babies.
The Legislature should pass Medicaid expansion. Texas is one of just 10 states that continues to reject Medicaid expansion. As a result, Texas workers below the poverty line typically are not eligible for health insurance through Medicaid. Under Medicaid expansion, an estimated 1.4 million uninsured low-wage Texans would become eligible for Medicaid health insurance.
Congress should extend advanced premium tax credits. Since Congress approved these health coverage tax credits — known as APTCs — through the American Rescue Plan Act of 2021, they have reduced or eliminated health insurance premium costs for millions of people and helped boost record enrollment in HealthCare.gov insurance plans.
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