Texas Continues to Lead Nation in Uninsured Adults and Kids
By David Doolittle


Everything is bigger in Texas, right? 

That’s usually something to brag about, but when it comes to uninsured residents, including children, Texas has a pretty big problem – and it’s getting worse. 

As of 2018, 11.2% of Texas children younger than 19 were uninsured, up from 10.7% in 2017, according to data the Census Bureau released last week. 

All told, Texas has led the nation in uninsured residents over the past two years, Census data show. In 2018, a little more than 5 million Texans, or 17.7% of the population, lacked health insurance. That’s up slightly from 2017, when 4.8 million (17.3%) Texans were uninsured. 

Several factors contribute to Texas’ uninsured rate, including falling enrollment in children’s Medicaid and the Children’s Health Insurance Program (CHIP). During the 2019 legislative session, the Texas Medical Association vigorously advocated for passage of legislation to eliminate onerous, repetitive paperwork that results in an estimated 50,000 eligible children losing coverage each year. 

According to the Texas Health and Human Services Commission, 2.8 million Texas children were enrolled in children’s Medicaid in July, when most recent data were available. That number has dropped steadily since October of 2016, when a little more than 3 million children were enrolled. 

In addition, the Trump Administration's new rule seeking to limit access to green cards for immigrants who receive Medicaid and other government benefits also contributes to Texas’ uninsured crisis. The rule is scheduled to take effect Oct. 15, but physicians across Texas report that fear and confusion generated by the new rule already has resulted in parents foregoing Medicaid or CHIP for their children, even for children with chronic conditions, even though the rule clearly exempts children. 

In December 2018, then-TMA President Doug Curran, MD, predicted the negative impact of the rules and submitted a letter urging the U.S. Citizenship and Immigration and Services to withdraw the proposed rule. 

"Adoption of the rule will worsen Texas’ sky-high rate of uninsured, already the highest in the country, and immeasurably harm the health and well-being of Texas and Texans," Dr. Curran wrote. He also pointed out that a higher rate of uninsured would "jeopardize the financial health of thousands of physician practices."

Last Updated On

September 30, 2019

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David Doolittle


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Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

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