Health & wellness
BY HANNAH NORTON
About 5 million Texans, or 16.4% of the state population, did not have health insurance in 2023, according to data from the U.S. Census Bureau. Texas’ uninsured rate was higher than any other state and more than twice the national rate of 7.9%. “Texas leads the nation in a lot of good ways, but this is one of those things we don’t want to be leading the nation in,” said Annie Spilman, executive director of Texans for Affordable Healthcare. Advocates are calling on the Texas Legislature to expand Medicaid eligibility and cut regulations that have contributed to rising health insurance costs in recent years. 5M Texans were uninsured in 2023
The big picture
For three years in a row, Texas health insurance premiums have increased by over 5% annually, according to the Texas Association of Health Plans, a trade association representing insurers. “The last several years, we’ve had the Legisla- ture adding a lot more requirements—what we call mandates—to health insurance that go above … the federal requirements,” said Blake Hutson, director of public affairs for the Texas Association of Health Plans. “Employers, who do provide the bulk of coverage in the state, are just increasingly facing higher and higher costs.” Texas has the third most health care mandates in the nation, according to Texans for Affordable Healthcare. Recent state mandates have limited the types of health coverage small businesses can offer, barred certain insurance providers from directing patients to mail-order pharmacies and more.
High health care costs
68%
Nearly half of Texans have employer- sponsored health insurance.
About 68% of Texas’ 3.2 million small businesses do not offer health coverage to their employees.
On average, Texas families pay $7,500 in annual employer-sponsored insurance premiums, while employers pay $15,000 per employee.
SOURCES: TEXICARE, TEXAS 2036/COMMUNITY IMPACT
Uninsured rate by state Texas’ uninsured rate is five percentage points higher than the next two states. Texas
Zooming in
16.4%
Georgia
costs when the cost is made up of something that reflects no sense of reality. There’s no incentive for insurance companies to pay less and the system of health care delivery we have today demands the lack of transparency for it to work.” In a Dec. 10 report, the Senate Health and Human Services Committee said lawmakers should look into ways to increase “innovative, alternative” health coverage options and consider requiring insurance providers to publicly list their prices to help people shopping for coverage.
A lack of transparency is driving high health insurance costs, members of the Texas Senate Health and Human Services Committee said May 14. Sen. Charles Perry, R-Lubbock, said giving peo- ple the true costs of medical services—“the needle, the doctor, the electricity and the bed”—could help lower insurance premiums and make coverage more accessible. “We could get really honest about what premi- ums and stuff can and should be,” Perry said. “It’s really frustrating to talk about health insurance
11.4%
Oklahoma
11.4%
Nevada
10.8%
Florida
10.7%
SOURCE: U.S. CENSUS BUREAU/COMMUNITY IMPACT
Also of note
Groups served by local health centers Uninsured Texans can visit federally qualified health centers, which offer medical care regardless of insurance coverage or a patient’s ability to pay. 75 FQHCs serve 1 in 17 Texans across 127 counties. 34% of patients uninsured 34% Medicaid 23% private insurance 7% Medicare 2% CHIP or other
About 750,000 Texans are in the “coverage gap,” according to policy nonprofit Texas 2036, meaning they make too much money to qualify for Medicaid and too little to receive subsidized coverage through the federal health insurance marketplace. Texas would spend about $700 million annually to expand Medicaid and receive $7 billion in federal funds, House budget analyst Eva DeLuna Castro said.
Texas is one of 10 states that have not expanded Medicaid, a state- and federally- funded health coverage program. Texans can qualify for Medicaid based on a combination of factors, including income, household size, pregnancy or disability status and age. In states with expanded Medicaid, residents can qualify based on income alone, according to the federal government.
SOURCE: TEXAS ASSOCIATION OF COMMUNITY HEALTH CENTERS/COMMUNITY IMPACT
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