Texas Ranks Number One for the Uninsured

Texas is the uninsured capital of the United States. More than 5.5 million Texans – including 1.4 million children – lack health insurance. The uninsured are up to four times less likely to get health care on a regular basis. They also are more likely to die from health-related problems. 

Who are the Uninsured?

The uninsured includes people who cannot afford private health insurance; who work in small businesses that do not offer insurance; who simply choose not to purchase health insurance, even though they can afford it; who are eligible—but not enrolled—in government sponsored programs such as Medicaid or the Children’s Health Insurance Plan (CHIP); and recent immigrants.

According to a summary of national data by the Congressional Budget Office (CBO), groups with a high likelihood of lacking health insurance include:

• People in families with income below 200 percent of the poverty level;
• Hispanics;
• Young adults, age 19 to 34;
• People in families in which the adults worked either part-time or only part of the year; or
• Individuals in fair or poor health status who are significantly more likely than others to be uninsured for longer periods.

Financial Impact of Texas’ Uninsured Crisis

Without a regular physician in charge of their care – a medical home, uninsured people seek care in the emergency room, the most expensive setting they could possibly choose. A condition that could be treated in a doctor’s office, such as an ear infection costs $170 in the emergency room versus $55 in a family physician’s office.

Taxpayers, Texans with insurance, and employers who offer health benefits also pay extra for caring for the uninsured. Families USA estimated the total cost for Texas in 2005 to be more than $9.2 billion. Of that:

• The patients and their families pay about half ($4.6 billion);
• Government health programs pay one-sixth ($1.6 billion); and
• Those with private health insurance subsidize the remaining third ($3 billion).

Health Insurance Coverage by Geographic Areas in Texas

Provisional Estimates of the Uninsured for Metropolitan Areas in Texas, 2005

Counties in Texas with Highest Uninsured Rates

In Texas, 35 of the state’s 254 counties account for 80 percent of the uninsured. A common misconception is that the uninsured are concentrated in the counties along the Texas - Mexico border. Five counties – Harris, Dallas, Bexar, Tarrant and El Paso – account for close to half of the statewide total of uninsured. Within these counties are the cities of Houston, Dallas, San Antonio, Fort Worth and El Paso (TDI, 2003). Of these five counties, only El Paso County borders Mexico.