Once Again, Texas Still the Worst in the Nation When it Comes to the Uninsured

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We are currently in the thick of the third open enrollment period for the Affordable Care Act, the time when Texans can shop around and enroll in a health insurance plan using the federal insurance marketplace at healthcare.gov. As much as Republicans have derided Obamacare, Texans have already benefitted immensely from the Affordable Care Act — more than 900,000 people have gotten covered over the past two years. Though these numbers are impressive, a new study suggests that it’s still not enough, because Texas is still the state with the highest uninsured population, even after the Affordable Care Act.

According to a new study from the financial group WalletHub, Texas ranks dead last in the percentage of residents who still lack health insurance. WalletHub found that 19.06% of Texans are still uninsured, a drop of about 5% from 2010, before the Affordable Care Act became law. In comparison, the state that ranked first, Massachusetts, had only 3.28% uninsured. California, a state that has a large population and has cooperated with Obamacare, saw its uninsured rate fall by over 6% to about 12% uninsured, placing it in the middle of the list at position 36.

Vulnerable Texans are faring the worst. Not only does Texas rank last overall when it comes to the uninsured, Texas is also dead last when it comes to the percentage of children who are uninsured. 11% of Texas kids lack health insurance, a rate that is nearly double the national average. People who are white and higher income are most likely to have health insurance, while low-income minority populations are still uninsured. According to the WalletHub report:

  • The uninsured rate for whites is 32.85 percent lower than that for blacks.
  • The uninsured rate for whites is 63.92 percent lower than that for Hispanics.
  • The uninsured rate for higher-income households is 72.25 percent lower than that for lower-income households.

The differences are staggering — and shameful.

Why is Texas so much worse off than the rest of the country? As we’ve covered many times before, much of the answer lies in the fact that Texas Republican leadership like Greg Abbott steadfastly refuse to participate in the Medicaid expansion that would insure over 1 million Texans. Don’t just take my word for it, take a look at the chart below, from WalletHub, that shows the strong and significant differences between states that did and did not expand Medicaid:


Uninsured Rate Medicaid 2014 v3.

Source: WalletHub

At this point, refusing Medicaid expansion is the biggest obstacle holding Texas back from a dramatic reduction in the number of residents who are uninsured. There’s really no good reason for Republicans to keep on refusing to expand Medicaid — not only is the continued refusal forcing poor Texans to make harrowing choices between their healthcare and other necessities, it is straight-up costing Texas a whopping $10 billion.

Increasing tax penalties for not buying insurance mean that this year’s open enrollment period will probably lead to a few more Texans getting insurance this year who may have previously been uninsured, and that’s a good thing. But that difference is simply not enough. If Texas truly wants to move forward and compete with other better covered and healthier states, Medicaid expansion is a must. And as long as Republican leaders refuse to cooperate, get used to seeing Texas at dead last in the nation for a long time to come.

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About Author

Katie Singh

Katie grew up in Austin and has been involved in Texas politics since 2004. She has been a part of several campaigns, from state house races to working at President Obama's campaign headquarters in 2012. She loves public policy, public health, and tacos. Katie tweets from @kasingh19.

1 Comment

  1. TEXAS was largest “worst” government in the 2011-13 American State Litter Scorecard.
    Three of (both) top TRAVEL+LESIURE and FORBES “Dirtiest Cities” (2010-2013) are in Texas:
    Dallas, Houston, San Antonio–More dirty, unhealthy cities than any other U.S. state!

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