Census Shows Texas Had Nation’s Worst Uninsured Rate for Kids and Adults in 2024
For Immediate Release
September 11, 2025
Contact: Peter Clark, [email protected]
Health Care Experts Warn More Texans Will Lose Insurance if Congress Fails to Extend Enhanced Subsidies for HealthCare.Gov Plans
Austin - Today the U.S. Census Bureau released new data showing that Texas had the nation’s highest rates of children and adults going out without health insurance in 2024. The report found that last year 21.6% of Texas adults age 19–64 and 13.6% of Texas children did not have health coverage. The Texas uninsured rate for kids is more than twice the national children’s rate of 6.0%. Texas also had the highest overall uninsured rate at 16.7% and the most people without insurance at 5.1 million.
“We’re deeply concerned that Texas kids are missing out on check-ups, medications when they are home sick from school, and other vital health care,” said Alec Mendoza, Senior Policy Associate for Health at Texans Care for Children. “Health insurance is an essential piece of the puzzle for keeping kids healthy.”
Health care experts warned that the uninsured rate will grow even higher if Congress allows enhanced “Premium Tax Credits” for HealthCare.gov insurance plans to expire on December 31, 2025. The enhanced subsidies, which Congress passed in 2021 and extended in 2022, have reduced monthly premiums for Texans enrolling in these health plans — helping to drive enrollment in HealthCare.gov plans from 1.3 Texans in 2021 to four million Texans today.
“If Congress fails to step up and extend the enhanced subsidies for Americans who get insurance plans through HealthCare.gov, we know that health care costs will skyrocket for families across Texas and the whole country,” said Lynn Cowles, Director of Health and Food Justice at Every Texan. “Some Texas families will be paying hundreds of extra dollars each month to cover their health care costs if Congress drops the ball.”
For example, monthly insurance payments for a 60-year-old couple in Texas who earn $82,000/year would increase by $18,000 per year if Congress lets the enhanced Premium Tax Credits (PTCs) expire, according to the Center on Budget and Policy Priorities. Allowing the enhanced PTCs to expire could lead to nearly one million Texans losing their health insurance, according to KFF. Those losses come on top of the estimated 480,000 Texans who will lose health coverage because of the mega-budget bill that Congress passed in July — including 350,000 Texans who will become uninsured due to the bill’s changes to HealthCare.gov enrollment.
Whether or not Congress extends the increased PTCs, the original PTCs that have been available since the beginning of the Affordable Care Act (ACA) would remain in place.
Health care experts urge everyone who is on an ACA plan right now to go to HealthCare.gov during the Open Enrollment period when it starts on November 1, 2025. People who don’t have health insurance from their employers and ACA enrollees can fill out the 2026 application and see if there is a plan that they can afford, even if it is not the plan they are on right now. Applicants who are unsure about which plan to pick or how plans work can reach out to a local ACA Navigator or Certified Application Counselor for guidance. All ACA plans, regardless of cost or insurer, cover preventive care at no cost to enrollees. Even people who have plans with high deductibles can get preventive care for no cost, if they are enrolled.
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