The State of Health Insurance in Texas: 10 Stats You Should Know

Healthcare industry

Texas does many things well, but health insurance is not one of them. Despite being the second-most populated state in the country and having world-class doctors, hospital systems, and medical facilities, Texas lags behind in some of the most basic healthcare measures for its residents.

10 Texas Health Insurance Stats

  1. Texas has by far the highest rate of uninsured residents of any state, at 18% of Texas uninsured residents in 2021 a slight drop from 18.4% in 2020.

  2. This is nearly twice the national average percentage of uninsured people. In 2021, the national average of uninsured residents was 8.6%.

  3. With a reported population of roughly 29.5 million residents, these numbers reflect the reality that 5.2 million Texas residents are uninsured.

  4. Out of the insured residents of Texas, 46% have insurance solely through their employer.

  5. About another 27% of the population of Texas is insured through either Medicaid, Medicare, or some combination of these two health insurance programs and private insurance. Medicare is a federal program providing health insurance for U.S. residents over the age of 65 or under 65 with a disability, and as a federal program, it’s run basically the same from state to state. Medicaid is an assistance program for low-income residents of all ages, and usually, the patient will not have to pay anything for covered medical expenses, except sometimes a small co-pay. Medicaid varies by state; it is run by state and local governments within federal guidelines.

  6. Texas has not expanded its Medicaid program, despite repeated proposals to do so. Medicaid expansion comes with a 9-to-1 match from the federal government, meaning for each $1.00 the state puts into the program, the federal government provides $9.00. The 39 states that have taken part in Medicaid expansion have lower numbers and rates of uninsured people, per the Texas Tribune.  Texas medicaid will need to consider steps as uninsured rates rise.

  7. Approximately 6% of the Texas population is only insured through non-group, AKA individual coverage. Individuals, usually self-employed or those who are not eligible for their employer-provided healthcare plans, often purchase this coverage through the Affordable Care Act, meaning insurance plans bought in the healthcare marketplace. While this coverage offers fewer plan options and usually costs more than other types of insurance, the federal government subsidizes many of the plans, based on income.

  8. “Insurance costs keep going up, and Texans are often paying more than people in other states.” (KXAN) In 2020, Texans spent an average of 14.2% of the state’s median income on worker’s insurance premiums and deductibles. While the median income in Texas is lower than most other states, the cost of insurance is more.

  9. Residents in this Texas County have the highest medical debt in the entire country. A whopping 23% of Tarrant County residents (Fort Worth area) carry medical debt of $800 or more — that’s 1 in 4 people. With the U.S. average at 13%, well, the Tarrant County figure is downright depressing.

  10. Average health insurance premium costs for an individual in Texas is $7183 per year. While Texas isn’t the most expensive, when compared to the state's median income, the amount Texans pay as a portion of their income is one of the highest in the country. (Not to mention, health insurance premiums have risen 35% since 2013.)

How to Find Affordable Health Insurance in Texas

Enrolling in health insurance coverage is an important way Texans can take control of their own health and well-being, despite rising costs. You can buy health insurance plan the Health Insurance Marketplace, through a broker, insurance agent, or directly from insurance companies. If you think you might be eligible for a health care subsidy, start by checking out options on Important is that if you're shopping for health insurance make sure it is...well, ACA-compliant health insurance. Health sharing ministries and other non-insurance options might look like health insurance but they aren't.

For small business owners, looking for group health insurance that you can afford and employees will like might seem unattainable. We get it. It feels like the cards are stacked against small businesses, and, well, they kind of are. We get into the nitty gritty details here: 4 Sad Truths About Small Business Health Insurance that Insurance Companies Won't Tell You. The good news is that Decent has found a way to make good health insurance affordable for small businesses. As a professional employer organization (PEO), we band businesses together to give them the size and scale they need to access decent healthcare coverage with features like free primary care and zero-dollar medical deductibles. Check out Decent’s small group health plans and contact us at to learn more.

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