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Census Shows Texas Has Double The Uninsured Rate Of Nearest Neighbors And Worst Rate In Country

The refusal by state Republicans to accept the Medicaid expansion of the Affordable Care Act (commonly referred to as Obamacare) continues to keep the rates of the uninsured in Texas high. According to a new report from the U.S. Census, the state has the highest rate of people without medical coverage in the country, and twice that of our nearest neighbors.

The report shows that a whopping 16.6 Texans are uninsured, or one in six residents. That’s more than double the national average of 8, as well as that of New Mexico (8.2 percent) and Louisiana (6.9 percent). Only Oklahoma, the state with the second-highest rate, is close to Texas with 11. 7 percent, but even then, the Lone Star State is 50 percent higher.

Even more disturbing, Texas leads the nation in terms of uninsured children. Our rate is 10.9 percent. That is, again, more than double the national average.

The uninsured rate is higher across all racial groups, including white, Black, Asian, Hispanic, and Native American.

The number is almost certainly an undercount. The Census was conducted during the height of the COVID pandemic. During that time, Medicaid restrictions were loosened and many poor Texans were able to gain or keep coverage. Those changes ended this year, and hundreds of thousands of Texans have either lost or are in the process of losing their coverage.

Since the passage of the Affordable Care Act in 2010, Texas Republicans have staunchly refused to participate in the Medicaid expansion despite the federal government fronting 90 percent of the cost. Nearby red states like Arkansas and Louisiana have since accepted the expansion, which is why their rates are more in line with the national average.

Because of the wording of the Affordable Care Act, Texas has more than a million residents who fall into the gap between what the state deems low enough income to qualify for coverage and the limit for the federal insurance exchange to offer free or heavily discounted coverage. During the two previous legislative sessions, expansion gained some popularity, even among Republicans, but they ultimately passed only minor adjustments for pregnant people.

As recently as November 2022, Governor Greg Abbott accused the  Medicaid expansion of being a “tax increase waiting to happen.” He encouraged Texas to get health insurance through employers, neglecting the hundreds of thousand of Texans who either cannot work or whose jobs do not provide health insurance. Only half of the state’s private employers offer health benefits, and that number drops to 25 percent for companies with fewer than 50 employees.

Childless adults with disabilities who have been unable to obtain coverage through Social Security are also locked out of the system, even if their income is zero dollars. Expanding Medicaid would cover people in that category.

Until Texas Republicans relent, the state’s rate of uninsured residents, including children, will continue to far outpace the rest of the nation.

Jef Rouner
Jef Rouner
Jef Rouner is an award-winning freelance journalist, the author of The Rook Circle, and a member of The Black Math Experiment. He lives in Houston where he spends most of his time investigating corruption and strange happenings. Jef has written for Houston Press, Free Press Houston, and Houston Chronicle.


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