The number of insured people in the US has increased by 19 million people since implementation of the Affordable Care Act’s (ACA’s) coverage reforms in 2014, but the increase has occurred unevenly across states. While every state has seen coverage growth, states that expanded Medicaid eligibility have seen the largest increases in coverage.
Texas has the country’s highest uninsurance rate, with 4.7 million people younger than 65 estimated to be uninsured in 2018. We estimate that 19 percent of people in that age group are uninsured in 2018, more than 70 percent higher than the national rate of 11 percent. Although the uninsurance rate remains high in Texas, it represents a significant increase in coverage across a diverse group of residents since ACA implementation.
Urban Institute researchers have analyzed the characteristics of people who are uninsured in Texas both statewide and in local areas. The statewide analysis is described in a research brief. We have also produced fact sheets for 41 Texas counties or groups of counties that illustrate the substantial variation in the uninsured rate and characteristics of the uninsured population. Find these fact sheets below or within a state map.
The estimates in the brief and fact sheets are produced using the Urban Institute’s Health Insurance Policy Simulation Model and reflect characteristics of the state’s population in 2018.
Read the brief:
The Uninsured in Texas: Statewide and Local Area Views
Matthew Buettgens, Linda J. Blumberg, and Clare Wang Pan
December 12, 2018
Local estimates of the uninsured and their characteristics:
- Panhandle Regional Planning Commission, Amarillo - Armstrong, Briscoe, Carson, Castro, Childress, Collingsworth, Dallam, Deaf Smith, Donley, Gray, Hall, Hansford, Hartley, Hemphill, Hutchinson, Lipscomb, Moore, Ochiltree, Oldham, Parmer, Potter, Randall, Roberts, Sherman, Swisher, and Wheeler Counties
- South Plains Association of Governments, Lubbock - Bailey, Cochran, Crosby, Dickens, Floyd, Garza, Hale, Hockley, King, Lamb, Lubbock, Lynn, Motley, Terry, and Yoakum Counties
- North Texas (Wichita Falls) - Archer, Baylor, Clay, Cottle, Foard, Hardeman, Jack, Montague, Wichita, Wilbarger, Wise, and Young Counties
- Texoma COG - Cooke, Fannin, and Grayson Counties
- Hunt and Rockwall Counties
- Ark-Tex COG - Bowie, Cass, Delta, Franklin, Hopkins, Lamar, Morris, Red River, and Titus Counties
- East Texas - Anderson, Camp, Cherokee, Gregg, Harrison, Henderson, Marion, Panola, Rains, Rusk, Smith, Upshur, Van Zandt, and Wood Counties
- Kaufman County
- Collin County
- Denton County
- Ellis County
- Johnson County
- North Central Texas - Erath, Hood, Palo Pinto, and Somervell Counties
- Dallas County
- Parker County
- Tarrant County
- West Central Texas COG, Abilene - Brown, Callahan, Coleman, Comanche, Eastland, Fisher, Haskell, Jones, Kent, Knox, Mitchell, Nolan, Runnels, Scurry, Shackelford, Stephens, Stonewall, Taylor, and Throckmorton Counties
- Concho Valley - Borden, Coke, Concho, Crockett, Dawson, Glasscock, Howard, Irion, Kimble, Martin, Mason, McCulloch, Menard, Reagan, Schleicher, Sterling, Sutton, Tom Green, and Upton Counties
- Midland-Odessa Area - Ector, and Midland Counties
- West Texas - Andrews, Brewster, Crane, Culberson, Gaines, Hudspeth, Jeff Davis, Loving, Pecos, Presidio, Reeves, Terrell, Ward, and Winkler Counties
- El Paso County
- Central Texas - Bell, Burnet, Coryell, Hamilton, Lampasas, Llano, Mills, and San Saba Counties
- Brazos Valley - Brazos, Burleson, Grimes, Leon, Madison, Milam, Robertson, and Washington Counties
- East Central Texas - Bosque, Falls, Freestone, Hill, Limestone, McLennan, and Navarro Counties
- Deep East Texas - Angelina, Houston, Jasper, Nacogdoches, Newton, Polk, Sabine, San Augustine, San Jacinto, Shelby, Trinity, Tyler, and Walker Counties
- Orange and Hardin Counties
- Jefferson County
- Houston-Galveston Area - Austin, Brazoria, Chambers, Colorado, Liberty, Matagorda, Montgomery, Waller, and Wharton Counties
- Harris County
- Galveston County
- Fort Bend County
- Capital Area - Bastrop, Caldwell, Fayette, Hays, Lee, and Williamson Counties
- Travis County
- Golden Crescent - Calhoun, DeWitt, Goliad, Gonzales, Jackson, Karnes, Lavaca, Victoria, and Wilson Counties
- Alamo Area - Atascosa, Bandera, Blanco, Comal, Frio, Gillespie, Guadalupe, Kendall, Kerr, and Medina Counties
- Bexar County
- Middle Rio Grande Development Council - Dimmit, Edwards, Kinney, La Salle, Maverick, Real, Uvalde, Val Verde, and Zavala Counties
- South Texas (Laredo) - Duval, Jim Hogg, Live Oak, McMullen, Starr, Webb, and Zapata Counties
- Coastal Bend - Aransas, Bee, Brooks, Jim Wells, Kenedy, Kleberg, Nueces, Refugio, San Patricio, and Willacy Counties
- Cameron County
- Hidalgo County