According to recently released census data, Texas has the highest uninsured rates in the country, with a full 26.3 percent of Texas residents lacking health insurance coverage. Massachusetts, home to the health laws that most closely resemble the Affordable Care Act, has the lowest rate, with only five percent lacking insurance.
This breakdown of the results by county using data from the American Community Survey (ACS) shows just how bad some parts of Texas have it. For an average of 26 percent uninsured, there have to be some pretty high rates of uninsured to balance out the places like Williamson County, where only 18 percent are uninsured. And indeed, in Hudspeth County, the uninsured rate is a disturbing 41 percent, and almost every county along the U.S.-Mexico border has an uninsured rate above 30 percent. And if you think it has to do with being along the border, think again – all of the border counties in New Mexico, Arizona and California have uninsured rates below 28 percent.
The interactive version of the map (which allows you to better see the county level data) can be found here.
One cause for hope is that the census data in the uninsured map came from ACS data collected from 2008 – 2010, and the health policy landscape has certainly changed since then. More recent census data, which comes from the 2012 Current Population Survey Annual Social and Economic Supplement, shows that the number of uninsured actually fell in the past year because of health reform. It was the first time in four years that the rate dropped, and it was the largest percentage drop in the rate since 1999. Most of it came from young people becoming insured – a group that can now stay on their parents' private insurance plans until they are 26 years old. The rate was also boosted by more people gaining public coverage like Medicare and Medicaid. So the landscape in Texas may not be as bleak as the ACS map suggests, though the newer and potentially more positive data has not yet been released in a format that allows for comparison by state and county.
The increase in insurance rates are just a preview of things to come when the rest of the Affordable Care Act's coverage-expanding provisions kick in in 2014. At that point, 30 million people who would not otherwise be covered are expected to gain coverage by 2022. And Texas clearly has a lot of room to gain.