More Texans are insured now than four years ago — but the state is still home to 4.5 million people without health coverage, the largest share in the country.

A new United States Census Bureau report shows the percentage of uninsured Texans dropped from 22.1 percent in 2013 to 16.6 percent in 2016. Despite the drop, Texas still reported the highest uninsured rate of all 50 states — and almost double the national uninsured rate of 8.8 percent.

Texas' GOP leaders have grappled with closing the state's coverage gap, but haven't pursued the most direct path, expanding Medicaid eligibility under the Obama-era Affordable Care Act. Texas is one of 19 states that has declined to extend this subsidized coverage to very poor adults. The uninsured rate for Medicaid “expansion states” in 2016 was 6.5 percent, compared to 11.7 percent in states that did not expand eligibility.

Anne Dunkelberg, associate director of the left-leaning Center for Public Policy Priorities, said in a press release that she was pleased to see more insured Texans under the Affordable Care Act, but that "all Texans will see health benefits and cost savings if Texas follows the lead of the majority of states — including very conservative states — by expanding coverage for these families using federal Medicaid dollars."

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But Vance Ginn, senior economist for the conservative Texas Public Policy Foundation, said states with expanded Medicaid coverage do not necessarily improve residents' health outcomes.

"Oftentimes those on Medicaid end up on a waiting list for quite a while so they end up at an ER or not going to a doctor at all, similar results to having no insurance," Ginn said.

For expansion states, the uninsured rate ranged from 2.5 percent in Massachusetts to 14 percent in Alaska. For non-expansion states, the rates ranged from 5.3 percent in Wisconsin to 16.6 percent in Texas. 

Disclosure: The Center for Public Policy Priorities and the Texas Public Policy Foundation have been financial supporters of The Texas Tribune. A complete list of Tribune donors and sponsors can be viewed here

 

Read related Tribune coverage:

  • As Republicans debate health care reform, there is one issue on the mind of many Texas families: Medicaid reform. [Full story]

  • With a Republican president in the White House, Texas health officials are seeking to restore federal family planning funding they gave up under the Obama administration to take a stand against Planned Parenthood. [Full story]

  • In Wednesday's dawn-to-dusk fight over repealing the law that served as a central campaign issue for Republicans over the last four election cycles, Texans were right in the middle. [Full story]

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