Interactive: Enrollment in Texas' Health Care Programs Increasing

Increasing enrollment in Texas’ health care programs is no secret, and neither is the multibillion-dollar Medicaid bill awaiting lawmakers next legislative session, because they didn’t budget for enrollment growth. Experts on both sides of the political aisle believe the state will have to make an emergency expenditure next legislative session to cover the costs of the programs.

There were nearly 3.6 million Texans enrolled in Medicaid as of June 2011, the most current available data — a 16 percent increase in enrollment compared with June 2009. The Children’s Health Insurance Program, as of December 2011, covered an additional 596,000 children. And the Women’s Health Program, as of June 2011, covered nearly 130,000 women.

Use this interactive to compare the number of Texans enrolled in Medicaid, the Children's Health Insurance Program and the Women's Health Program. By clicking on the legend, you can remove or add a category from view in order to more clearly compare how enrollment has changed for different groups of people.

Enrollment:
Medicaid | Children's Health Insurance Program | Women's Health Program

 

Texas’ expenditures on state health programs have increased by more than 150 percent since 2000, and cost the state $33.7 billion in fiscal year 2011, according to the Texas Legislative Budget Board. The federal government pays nearly two-thirds of the costs of Texas’ health and human services agencies, but the state appropriated $55.4 billion, or 32 percent of the total budget, for its share in the 2012-13 biennium.

Those billions budgeted by Texas lawmakers don’t account for increased enrollment, and instead of budgeting more money, lawmakers passed a variety of measures to cut the costs of Medicaid in 2011. The cost-cutting measures include expanding managed care plans across the state and requiring the Health and Human Service Commission to develop “quality-based payment systems” that reward better patient outcomes and reduce preventable readmissions.

The reforms are under way, but far from finalized. The HHSC has formed committees to study and select ways to reduce costs, such as identifying “the ten most overused, unnecessary medical services” and decreasing Medicaid payments for those services. And in December, the federal government approved the state’s plan to expand managed care, which in effect outsources public insurance coverage to private insurers for a set fee each month.

Medicaid enrollees in metropolitan areas such as Houston, Dallas and San Antonio already use managed-care plans. The rollout of managed-care plans across the state is most controversial in South Texas, where a greater percentage of the population is enrolled in Medicaid. Lawmakers from South Texas argued during the legislative session that it would limit Medicaid patients' access to health care, because fewer doctors in an already overcrowded system would accept Medicaid clients.

The map and sortable table below show Medicaid enrollment by county. The Texas Tribune calculated the percentage of each county population covered by Medicaid using Health and Human Services enrollment data for June 2011 and 2011 population projections from the Texas Department of State Health Services. Therefore, the percentage of the population enrolled should be considered a rough estimate.

County Total Enrollment 2011 Population Projection Estimated Percent of Population Total Children Under Age 19 Total Adults
Anderson 7,369 58,092 12.69 5,149 2,220
Andrews 1,886 14,413 13.09 1,381 505
Angelina 14,666 85,631 17.13 10,443 4,223
Aransas 3,156 28,050 11.25 2,157 999
Archer 486 9,555 5.09 302 184
Armstrong 137 2,293 5.97 81 56
Atascosa 8,310 46,605 17.83 5,961 2,349
Austin 3,133 29,283 10.70 2,377 756
Bailey 1,460 6,297 23.19 1,195 265
Bandera 1,889 21,635 8.73 1,314 575
Bastrop 9,911 84,458 11.73 7,453 2,458
Baylor 553 3,986 13.87 343 210
Bee 4,896 34,229 14.30 3,383 1,513
Bell 37,052 296,667 12.49 27,123 9,929
Bexar 267,352 1,660,689 16.10 199,478 67,874
Blanco 853 10,573 8.07 606 247
Borden 20 770 2.60 17 3
Bosque 2,274 17,866 12.73 1,604 670
Bowie 14,838 93,227 15.92 10,171 4,667
Brazoria 30,592 327,763 9.33 23,558 7,034
Brazos 19,660 177,942 11.05 15,252 4,408
Brewster 871 9,527 9.14 571 300
Briscoe 203 1,867 10.87 154 49
Brooks 2,384 7,837 30.42 1,550 834
Brown 5,821 40,084 14.52 3,793 2,028
Burleson 2,138 18,915 11.30 1,506 632
Burnet 4,578 49,102 9.32 3,431 1,147
Caldwell 5,920 39,415 15.02 4,273 1,647
Calhoun 3,215 23,500 13.68 2,443 772
Callahan 1,504 14,687 10.24 1,053 451
Cameron 110,253 425,569 25.91 84,473 25,780
Camp 2,526 13,611 18.56 1,912 614
Carson 379 6,781 5.59 262 117
Cass 4,746 30,615 15.50 3,056 1,690
Castro 1,487 7,292 20.39 1,214 273
Chambers 2,814 36,872 7.63 2,188 626
Cherokee 8,895 50,348 17.67 6,530 2,365
Childress 1,010 7,949 12.71 682 328
Clay 861 11,228 7.67 590 271
Cochran 599 3,454 17.34 427 172
Coke 306 3,929 7.79 187 119
Coleman 1,414 8,904 15.88 921 493
Collin 40,855 884,317 4.62 31,968 8,887
Collingsworth 555 3,141 17.67 405 150
Colorado 2,856 22,442 12.73 2,038 818
Comal 8,907 126,145 7.06 6,753 2,154
Comanche 1,955 14,308 13.66 1,356 599
Concho 333 3,824 8.71 233 100
Cooke 4,450 41,279 10.78 3,391 1,059
Coryell 5,937 81,691 7.27 4,312 1,625
Cottle 279 1,875 14.88 168 111
Crane 378 4,331 8.73 237 141
Crockett 473 4,621 10.24 347 126
Crosby 1,161 6,471 17.94 869 292
Culberson 444 2,685 16.54 295 149
Dallam 1,034 6,802 15.20 817 217
Dallas 380,075 2,460,277 15.45 307,081 72,994
Dawson 2,237 14,751 15.17 1,633 604
Deaf Smith 3,941 20,704 19.03 3,138 803
Delta 780 5,317 14.67 491 289
Denton 39,759 737,854 5.39 31,541 8,218
Dewitt 2,947 20,617 14.29 1,977 970
Dickens 287 2,786 10.30 196 91
Dimmit 2,829 9,688 29.20 1,892 937
Donley 397 3,873 10.25 259 138
Duval 2,723 11,932 22.82 1,727 996
Eastland 2,804 18,836 14.89 1,857 947
Ector 22,606 134,087 16.86 16,740 5,866
Edwards 293 2,216 13.22 193 100
Ellis 17,032 165,095 10.32 13,275 3,757
El Paso 158,775 782,541 20.29 119,789 38,986
Erath 4,091 40,189 10.18 3,105 986
Falls 2,900 18,762 15.46 1,880 1,020
Fannin 4,117 35,140 11.72 2,822 1,295
Fayette 2,346 25,631 9.15 1,571 775
Fisher 376 4,146 9.07 247 129
Floyd 1,101 6,833 16.11 866 235
Foard 183 1,577 11.60 105 78
Fort Bend 41,223 604,687 6.82 31,766 9,457
Franklin 1,320 11,109 11.88 965 355
Freestone 2,235 20,702 10.80 1,590 645
Frio 3,758 18,095 20.77 2,684 1,074
Gaines 2,432 16,670 14.59 1,895 537
Galveston 31,584 298,791 10.57 23,361 8,223
Garza 723 5,280 13.69 536 187
Gillespie 2,156 26,445 8.15 1,568 588
Glasscock 70 1,534 4.56 62 8
Goliad 875 7,781 11.25 637 238
Gonzales 3,754 20,544 18.27 2,851 903
Gray 2,977 22,879 13.01 2,186 791
Grayson 15,428 121,968 12.65 11,187 4,241
Gregg 19,879 124,477 15.97 14,025 5,854
Grimes 3,528 26,699 13.21 2,501 1,027
Guadalupe 12,862 133,722 9.62 9,982 2,880
Hale 6,494 37,136 17.49 4,943 1,551
Hall 612 3,842 15.93 438 174
Hamilton 1,056 9,019 11.71 612 444
Hansford 602 5,219 11.53 490 112
Hardeman 593 4,601 12.89 416 177
Hardin 6,194 52,467 11.81 4,254 1,940
Harris 611,847 4,176,561 14.65 493,732 118,115
Harrison 9,936 68,196 14.57 7,145 2,791
Hartley 294 5,836 5.04 205 89
Haskell 873 5,886 14.83 553 320
Hays 13,735 171,682 8.00 10,555 3,180
Hemphill 304 3,616 8.41 242 62
Henderson 12,339 82,195 15.01 8,480 3,859
Hidalgo 224,724 817,533 27.49 176,739 47,985
Hill 5,368 37,480 14.32 3,835 1,533
Hockley 3,619 23,917 15.13 2,743 876
Hood 4,944 56,151 8.80 3,695 1,249
Hopkins 5,204 34,842 14.94 3,584 1,620
Houston 3,773 24,643 15.31 2,365 1,408
Howard 5,020 33,487 14.99 3,605 1,415
Hudspeth 706 3,854 18.32 519 187
Hunt 11,497 91,250 12.60 8,224 3,273
Hutchinson 2,616 23,474 11.14 1,980 636
Irion 123 1,825 6.74 89 34
Jack 794 9,104 8.72 566 228
Jackson 2,041 15,447 13.21 1,500 541
Jasper 6,034 35,839 16.84 4,137 1,897
Jeff Davis 166 2,921 5.68 125 41
Jefferson 41,193 242,356 17.00 29,257 11,936
Jim Hogg 1,342 5,509 24.36 929 413
Jim Wells 9,110 42,742 21.31 6,085 3,025
Johnson 17,545 174,549 10.05 13,432 4,113
Jones 2,087 20,766 10.05 1,428 659
Karnes 2,291 16,968 13.50 1,454 837
Kaufman 12,598 111,955 11.25 9,899 2,699
Kendall 2,247 36,706 6.12 1,634 613
Kenedy 57 475 12.00 45 12
Kent 103 857 12.02 54 49
Kerr 5,600 47,170 11.87 4,157 1,443
Kimble 548 4,811 11.39 380 168
King 4 377 1.06 2 2
Kinney 500 3,447 14.51 353 147
Kleberg 5,692 31,853 17.87 3,889 1,803
Knox 638 4,251 15.01 408 230
Lamar 8,894 50,457 17.63 5,753 3,141
Lamb 2,668 15,666 17.03 1,959 709
Lampasas 2,450 23,120 10.60 1,747 703
La Salle 1,304 6,011 21.69 874 430
Lavaca 2,348 19,616 11.97 1,474 874
Lee 1,850 18,369 10.07 1,296 554
Leon 2,050 17,109 11.98 1,491 559
Liberty 11,944 83,061 14.38 8,663 3,281
Limestone 3,611 23,511 15.36 2,556 1,055
Lipscomb 273 3,174 8.60 221 52
Live Oak 1,213 12,395 9.79 829 384
Llano 1,880 19,580 9.60 1,273 607
Loving 7 65 10.77 3 4
Lubbock 38,807 269,648 14.39 29,125 9,682
Lynn 889 5,878 15.12 671 218
Madison 1,897 14,660 12.94 1,379 518
Marion 1,524 11,018 13.83 893 631
Martin 669 5,368 12.46 517 152
Mason 344 3,847 8.94 253 91
Matagorda 6,589 38,883 16.95 4,941 1,648
Maverick 15,690 55,968 28.03 10,904 4,786
McCulloch 1,445 8,724 16.56 984 461
McLennan 36,780 236,186 15.57 26,664 10,116
McMullen 46 882 5.22 25 21
Medina 6,142 46,249 13.28 4,278 1,864
Menard 302 2,443 12.36 194 108
Midland 15,041 131,349 11.45 11,269 3,772
Milam 4,204 26,678 15.76 2,934 1,270
Mills 653 5,585 11.69 456 197
Mitchell 1,053 9,803 10.74 715 338
Montague 2,503 20,340 12.31 1,724 779
Montgomery 41,812 498,672 8.38 32,506 9,306
Moore 3,274 21,176 15.46 2,715 559
Morris 2,375 13,559 17.52 1,573 802
Motley 128 1,416 9.04 74 54
Nacogdoches 10,146 64,815 15.65 7,405 2,741
Navarro 8,752 52,374 16.71 6,427 2,325
Newton 2,346 14,828 15.82 1,533 813
Nolan 2,641 14,275 18.50 1,811 830
Nueces 57,666 324,915 17.75 41,184 16,482
Ochiltree 1,186 10,087 11.76 990 196
Oldham 199 2,340 8.50 164 35
Orange 11,801 84,765 13.92 8,217 3,584
Palo Pinto 3,891 29,914 13.01 2,730 1,161
Panola 3,118 24,217 12.88 2,133 985
Parker 9,943 121,772 8.17 7,655 2,288
Parmer 1,377 10,244 13.44 1,086 291
Pecos 2,104 17,905 11.75 1,435 669
Polk 7,370 50,892 14.48 4,924 2,446
Potter 24,690 127,716 19.33 18,817 5,873
Presidio 1,920 8,792 21.84 1,117 803
Rains 1,408 11,138 12.64 1,001 407
Randall 8,240 121,738 6.77 6,166 2,074
Reagan 322 3,101 10.38 243 79
Real 533 3,383 15.76 338 195
Red River 2,079 14,400 14.44 1,223 856
Reeves 2,502 10,862 23.03 1,635 867
Refugio 1,004 7,044 14.25 635 369
Roberts 41 954 4.30 30 11
Robertson 2,966 16,982 17.47 2,039 927
Rockwall 5,104 91,069 5.60 3,995 1,109
Runnels 1,578 11,793 13.38 1,032 546
Rusk 6,721 50,284 13.37 4,767 1,954
Sabine 1,570 10,869 14.44 984 586
San Augustine 1,685 9,635 17.49 1,047 638
San Jacinto 3,871 28,714 13.48 2,777 1,094
San Patricio 11,603 71,094 16.32 8,321 3,282
San Saba 779 6,416 12.14 549 230
Schleicher 321 3,223 9.96 229 92
Scurry 2,045 17,264 11.85 1,464 581
Shackelford 295 3,480 8.48 217 78
Shelby 4,819 26,737 18.02 3,407 1,412
Sherman 255 3,378 7.55 213 42
Smith 28,277 210,929 13.41 21,117 7,160
Somervell 873 8,803 9.92 633 240
Starr 22,881 68,749 33.28 16,700 6,181
Stephens 1,426 10,313 13.83 1,033 393
Sterling 102 1,477 6.91 58 44
Stonewall 150 1,632 9.19 90 60
Sutton 414 4,679 8.85 315 99
Swisher 1,230 8,189 15.02 941 289
Tarrant 214,870 1,872,095 11.48 170,343 44,527
Taylor 18,736 131,663 14.23 13,369 5,367
Terrell 92 1,108 8.30 53 39
Terry 2,390 11,400 20.96 1,730 660
Throckmorton 161 1,887 8.53 111 50
Titus 6,000 32,432 18.50 4,900 1,100
Tom Green 14,409 103,640 13.90 10,136 4,273
Travis 116,411 1,011,063 11.51 90,070 26,341
Trinity 2,413 15,297 15.77 1,579 834
Tyler 2,796 22,222 12.58 1,908 888
Upshur 5,681 38,561 14.73 4,026 1,655
Upton 385 3,131 12.30 256 129
Uvalde 5,951 28,047 21.22 4,282 1,669
Val Verde 10,439 50,499 20.67 7,362 3,077
Van Zandt 6,571 54,189 12.13 4,616 1,955
Victoria 14,027 89,589 15.66 10,296 3,731
Walker 6,247 65,113 9.59 4,523 1,724
Waller 5,666 43,241 13.10 4,535 1,131
Ward 1,500 9,804 15.30 998 502
Washington 3,920 33,806 11.60 2,713 1,207
Webb 67,474 263,985 25.56 54,461 13,013
Wharton 6,570 44,008 14.93 4,954 1,616
Wheeler 562 5,130 10.96 413 149
Wichita 17,679 127,247 13.89 12,203 5,476
Wilbarger 2,320 15,333 15.13 1,649 671
Willacy 5,920 22,191 26.68 4,159 1,761
Williamson 29,878 458,392 6.52 23,254 6,624
Wilson 4,709 46,979 10.02 3,246 1,463
Winkler 1,008 6,506 15.49 684 324
Wise 5,659 62,974 8.99 4,385 1,274
Wood 4,973 45,678 10.89 3,340 1,633
Yoakum 1,011 8,362 12.09 756 255
Young 2,603 18,722 13.90 1,782 821
Zapata 3,704 15,608 23.73 2,889 815
Zavala 3,663 12,959 28.27 2,534 1,129
Unknown 7,706 n/a n/a 3,530 4,176
State of Texas 3,593,507 n/a n/a 2,748,916 844,591

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