Texas Uninsured Rate: Tops the Charts Fifth Year in a Row


Texas is, once again, back in the news for a rather embarrassing reason: The state has the highest uninsured rate in the country for the fifth year in a row. Most states would be eager to buck this trend, but Texas seems to be happy with the status quo. 

According to a poll released Friday by Gallup, 28.8% of adults in Texas lack insurance coverage. This is the highest for any state since Gallup started tracking insurance coverage in 2008. This also widens the gap between Texas and the state with the second-highest uninsured rate, Louisiana. Now 4.8 percentage points stand between the two — the largest number separating the first and second most uninsured states on record. Massachusetts, as you may have guessed, comes in with the lowest uninsured rate at 4.5%.

Unfortunately (oops, maybe?) Rick Perry has no public plans to deal with this problem, and instead chooses to attempt to shift focus onto the state’s largely healthy economy so no one will notice its unhealthy population.

Perry recently affirmed that he would be rejecting a Medicaid expansion that would have covered 1 million uninsured Texans, calling it a “a broken system” that would move the state “towards bankruptcy.” He’s instead demanded the flexibility to carry out his own plan to cover the uninsured, and has even asked for a block grant to cover the cost of the plan (which, for the record, he hasn't detailed). As you might imagine, the Federal government is shaking their head no. 

Other politicians in Texas are being more productive on the issue. Sen. Tommy Williams, the Republican chairman of the Senate Finance Committee, wrote an op-ed that ran in papers statewide advocating that Medicare recipients pay at least a small deductible for their care, which would help bring down the cost. Rep. Lois Kolkhorst, Republican chairwoman of the Public Health Committee, said Texas may release details on a suggested waiver may be out soon, much like the one Arkansas received that allowed the state to expand Medicaid by subsidizing private health insurance rather than using the state’s existing Medicaid program. 

While there are more vague ideas of solutions being tossed around in the Texas House, most of them have to do with paying local governments back for the cost of uncompensated care and not actually with spreading coverage. 

There are a lot of reasons why Texas has such a high number of uninsured. It’s a unique state, to be sure, and a lot of those unique issues result in an equally unique health care problem. For example, Texas has one of the lowest rates for employer-sponsored health care coverage in the nation, largely because much of the population works in retail and agriculture — two fields that rarely offer health care to their employers.

Also, with few exceptions the state sticks with federal minimums for Medicaid coverage and leaves the private market largely unregulated, leaving insurance companies to feel free to make insurance prohibitively expensive. While the Affordable Care Act will make it impossible for insurance companies to reject those with preexisting conditions after 2014 (so, theoretically, the percentage of uninsured in Texas would go down slightly), they've been rejecting pretty much everyone with a preexisting condition in Texas for quite some time and charging women and the elderly more for coverage. 

As Gallup points out, has a high number of immigrants and a growing number of Hispanics, a group that Gallup finds has the highest uninsured rate in the country at 40.1%. In 2010, non-citizens made up 29.3% of the state’s uninsured.

With unique problems come a need for unique solutions. Unfortunately, the state has had these problems for years and nothing has been done. The result is an ever-rising percentage of uninsured and, in turn, an increasingly unhealthy state. Texas can’t continue to rely on its economy for bragging rights — if it is going to continue to top the charts for job growth, people actually have to be healthy enough to go to work.