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Everything's Bigger in Texas - Even Our Uninsured Rate

If Texans are spending a sizable portion of their taxes towards public health care and a sizeable portion of their incomes on private health insurance, as a state we must be offering adequate access and coverage to health care for the majority of our citizens, right? Actually, not really – at least not when compared to the rest of the U.S.

According to the Commonwealth Fund State Scorecard on Health System Performance, Texas ranks 49^th (out of 51) for overall health system performance and 51^st for both access and equity.[1] With a 24 percent uninsured rate, Texas fares the worst in providing adequate access to health coverage and has shown to be the least equitable in providing health care access to minority and low-income groups. Texas also touts the largest rate of uninsured children.

Children 17 & Below Without Health Insurance, 2004

Source: The Annie E. Casey Foundation, National KIDS COUNT Database, 30 July 2007 <http://www.kidscount.org/sld/map.jsp?i=110&yr=&va=&dt=2>.

In fact, Texas' uninsured rate drives up the overall US uninsured rate - if Texas' rate of uninsured were to decrease, the nation's rate of uninsured would likely drop one percentage point.

Texas Uninsured Rate Compared to State Median & US Average

Data from Kaiser Family Foundation, Statehealthfacts.org.

While Texas constitutes only about eight percent of the non-elderly (65 or below) population, it accounts for around 12 percent of uninsured Americans under 65.[2] Of the non-elderly Texans who have health insurance, approximately 54 percent are covered by some form of employer-sponsored coverage as opposed to 61 percent of Americans overall.[3] For these individuals, an employer – either their own or that of someone they are related to – negotiates an insurance plan on their behalf, and in many cases pays some or all of the costs of the plan.

Medicare and Medicaid, the two major public health coverage programs that cover people who are deemed to be especially needy, because they are poor or elderly, have exceptional health care needs, or a combination of these factors, make up approximately 23.3 percent of those who have health insurance in Texas, and approximately 25.9 percent of Americans who are covered.[4] Medicare accounts for a lower percentage of state health coverage because the population is relatively younger in Texas than the US overall. Those who are not covered by either a public program or an employer sponsored plan fall into two last categories – the uninsured or private/individual insurance purchasers. Approximately five percent of the non-elderly both in Texas and in the US overall have private/individual health insurance.