Texas Leads Nation in Rise in Uninsured Children, Study Shows
By David Doolittle


The number of uninsured children nationwide climbed dramatically in recent years, with the biggest gains by far coming from the Lone Star State, according to a study released last week. 

Between 2016 and 2019, 726,000 more children went without health insurance – including almost 250,000 in Texas, the study by the Georgetown University Health Policy Institute’s Center for Children and Families shows. 

Overall, the nation’s rate of uninsured children rose one percentage point during those years, the largest annual jump in more than a decade, according to the report. 

Because the data was compiled before the COVID-19 pandemic, authors said the number of uninsured children is likely to be even higher this year. 

“After reaching a historic low of 4.7 percent in 2016, the child uninsured rate began to increase in 2017, and as of 2019 jumped back up to 5.7 percent,” researchers wrote. “These coverage losses occurred in a healthy economy with the lowest unemployment rate in decades prior to the economic shocks and job loss associated with the COVID-19 pandemic.” 

Much of the coverage losses are a result of federal cuts to outreach and enrollment assistance,  red tape interfering with families’ ability to maintain children’s Medicaid coverage, and federal immigration rules – known as public charge regulations – that deter parents from enrolling their children in Medicaid despite being eligible, the authors said. 

The Texas Medical Association strongly supports initiatives to meaningfully reduce the state’s uninsured rate. Texas leads the nation with more than 5 million uninsured residents, including 1 million children, according to data compiled by TMA and other organizations. 

In August, TMA president Diana Fite, MD, joined by 32 other physician, hospital, and consumer advocacy organizations, called on Gov. Greg Abbott to support comprehensive initiatives to extend health care coverage to more Texans, including providing 12 months of continuous coverage for children enrolled in Medicaid. 

In Texas, at least 350,000 uninsured children are eligible but not enrolled in Medicaid or the Children’s Health Insurance Program (CHIP), according to the Center for Public Policy Priorities

Among other findings in the Georgetown report:

  • 243,000 Texas children lost coverage from 2016-19 – a 32% increase. Florida saw the next-highest jump with 55,000.
  • Texas’ uninsured children rate climbed from 9.8% in 2016 to 12.7% in 2019, an increase of 2.9%.
  • 17.5% of Latino children in Texas were without coverage in 2019, well above the national average of 9.2%. 

In addition, seven of the top 20 counties with the highest number of uninsured children nationwide in 2019 were in Texas, with Harris and Dallas counties leading the way. The other five were Tarrant, Hidalgo, Bexar, Travis, and El Paso counties, the study shows. 

The report was based on the U.S. Census Bureau’s annual American Community Survey and defines children as being 18 years and younger.


Last Updated On

October 15, 2020

Originally Published On

October 14, 2020

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