Census Undercount Could Stifle Texas’ Health Services, Doctors Say

March 10, 2020 

Texas Physicians Urge Patients to be Counted

Texas physicians are urging patients to answer the upcoming U.S. Census to ensure the state won’t lose billions of dollars’ worth of health and human services funding – a loss that could harm the patients themselves. 

The Texas Medical Association’s (TMA’s) March Texas Medicine magazine cites a George Washington University study showing the state could lose about $300 billion in funding for Medicaid, the Children's Health Insurance Program (CHIP), adoption assistance, childcare, and foster care if the Texas population goes uncounted by just 1% more than the 2010 census results. Physicians are encouraging patients to be counted, to help themselves and their neighbors.

“The families that are most likely to be undercounted are also the people who will be hurt the most by lost services caused by undercounting,” says Lauren Gambill, MD, an Austin pediatrician who educates patients to participate in the census. “Just talking about it and creating awareness is important – whether that’s in the media, or writing about it, or talking about it personally with patients,” she said.

Texas physicians warn the funding loss would weaken medical services particularly in remote rural areas, low-income communities, and among immigrants, the homeless, and minority populations.

Undercounting statewide populations in the U.S. Census is a common flaw in the headcount, but the stakes are higher in 2020, doctors say.

In a preview of the 2020 census, a 2019 report from the Urban Institute predicts an undercount of the U.S. population of 0.3% to 1.2% – an undercount of 900,000 to 4.1 million people. The report also predicts a higher number of the African American and Hispanic populations are most likely missed in the count. Texas Counts, a statewide coalition of organizations promoting the census, says one-quarter of people, including minorities, live in hard-to-count areas, meaning the state is at high-risk for a significant undercount.  

Census undercounting commonly occurs where there’s confusion among respondents over who should be counted, and fear that the government will use the data for law enforcement purposes, including immigration control. As a result, a Pew Research survey found that black and Hispanic adults are more likely than white adults to say they will not respond to the 2020 census.  

Carla Laos, MD, an Austin pediatric emergency medicine physician, works with Dr. Gambill and others to promote the census among patients. The daughter of Peruvian immigrants, Dr. Laos says physicians are trusted members of the community and have a platform to tell reluctant patients they can protect medical services for their community if they respond to the census.

“As a woman of color, there is value in having someone like me who has become forward-facing and can talk to the community and immigrants and other people who look like me,” said Dr. Laos.

The census rollout begins on March 12, when households will receive Census Bureau mail with information on how to respond online, by phone, or by mail.

TMA is the largest state medical society in the nation, representing more than 53,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans. 


Contact:  Brent Annear (512) 370-1381; cell: (512) 656-7320

Marcus Cooper (512) 370-1382; cell: (512) 650-5336

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Check out MeAndMyDoctor.com for interesting and timely news on health care issues and policy.

Last Updated On

March 11, 2020

Originally Published On

March 10, 2020