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Report: Most Uninsured Texans are Employed U.S. Citizens

Many of the state's 5 million uninsured residents end up seeking care in hospital emergency rooms, where costs are much higher. (U.S.  Army)
Many of the state's 5 million uninsured residents end up seeking care in hospital emergency rooms, where costs are much higher. (U.S. Army)
December 17, 2018

HOUSTON – Unless Texas lawmakers make significant changes to health policies, the number of Texans without health insurance is projected to rise, according to a new report released by the Episcopal Health Foundation.

Foundation spokesman Brian Sasser says the report paints a clearer picture of just who lacks health coverage in the Lone Star State.

He notes many work full-time in stores, wait tables, build homes or care for children, but still cannot afford insurance.

"I think what may surprise some folks is that working Texans make up the majority of the uninsured in Texas,” Sasser points out. “In fact, two thirds of uninsured Texans live in working families."

More than half of Texans without coverage live in families that include at least one full-time worker, according to the report.

More than 4-in-10 live in families where at least one adult works at a company with more than 50 employees.

A majority of Texans say they want the state to expand Medicaid under the Affordable Care Act, which could insure more than a million residents.

Lawmakers argue the move could put taxpayers on the hook for Medicaid costs if the ACA implodes.

States that expanded Medicaid eligibility saw the largest increases in health coverage. Nationally, just 11 percent of people younger than 65 were uninsured in 2018, but in Texas 19 percent of people not old enough for Medicare coverage lacked insurance.

Sasser notes that people without coverage lack access to preventive care, and when they get sick many end up in the emergency room where costs are much higher.

"So when they go to the hospital and they can't pay for that because they don't have health insurance, that bill is passed onto somebody – whether it's the taxpayers or in higher premiums – and the cost goes down the line," he states.

The report confirms that Texas has the highest number of uninsured people in the nation, currently nearly 5 million residents. And 60 percent of uninsured Texans live in families earning less than $35,000 a year for a family of four.

More than 60 percent of Texans without coverage are Hispanic, compared with 24 percent white and 10 percent black.

Researchers also found that nearly two-thirds of uninsured residents are U.S. citizens.

Eric Galatas, Public News Service - TX