Texas maintains highest uninsured rate for children and adults in the country at 18% in 2021 – State of Reform


According to the US Census Bureau, Texas had the country’s highest uninsured rate in 2021 at 18% compared to the national average of 8.6% American Community Survey (ACS).

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Data was released last week showed that nearly 12% of children and a quarter of adults ages 19-64 (24.3%) in Texas were uninsured in 2021. Medicare, Medicaid, CHAMPVA and VACARE) plans in 50 states and the District of Columbia.

The report showed that the federal COVID-19 public health emergency response over the past two years has resulted in an increase in public coverage in the 36 states that have expanded Medicaid under the ACA. There was a sharp contrast in uninsured rates between these expansion states (6.6%) and the 14 non-expansion states (12.7%).

“Our state leaders need to do better to ensure Texans get the medical care they need, whether it’s a mother with a newborn baby coping with postpartum depression or a sick student who needs medication to get back to school.” , said Diana Forester, director of health policy at Texans Care for Children.

Under Texas law, Medicaid coverage is limited to low-income children, the elderly, people with disabilities, and pregnant women. An expansion would allow adults with incomes below the poverty line who are not normally insured to qualify for Medicaid.

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Many of these individuals do not receive health insurance through employers and do not earn enough to purchase private health insurance without subsidies available only to low- and middle-income Texans above the poverty line.

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The report also found that uninsured rates in Texas were higher than the national average across all racial and ethnic groups identified by the Census Bureau, with Hispanic and Native populations having the highest uninsured rates.

“By continuing to block Medicaid expansion, the governor and legislature are endangering the lives of Texans across the state and leaving millions of federal dollars on the table,” said Patrick Bresette, executive director of the Children’s Defense Fund Texas. “Her decision hurts Texans in every community, but it hits communities of color the hardest.”

The uninsured rate for children improved, falling from 12.7% in 2019 to 11.8% in 2021. However, the improvements have coincided with Public Health Emergencies (PHE) guidelines, which have allowed more children and mothers to remain enrolled in Medicaid by providing billions in federal relief to cover costs.

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The Biden administration has signaled that PHE relaxations will remain in place until January 2023.

Meanwhile, Texans Care for Children outlined actions lawmakers can take to enroll 400,000 uninsured Texas children who are eligible for health insurance but are currently unenrolled. Child health advocates calls for further reforms that will improve enrollment and access to care in the coming legislature.

Speaker of the Texas House of Representatives Dade Phelan lately appointed a committee Examine health care issues for the next session, including strategies to encourage school enrollment of children eligible for coverage. Phelan has also sworn Pass legislation that extends postpartum Medicaid coverage to a full year after childbirth for Texas mothers.





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