One in Five Uninsured Americans Lives in Texas

A new report has revealed that nearly one in five Americans without health insurance lives in Texas, where the state’s uninsured rate significantly exceeds the national average. According to U.S. Census Bureau data, 18.1% of all uninsured people in the country reside in this southwestern state.

Analysts attribute this gap to Texas’ decision not to expand Medicaid under the Affordable Care Act (Obamacare), which left a wide segment of low-income adults, including immigrants, without coverage. This has added pressure on hospitals—especially in rural areas—and weakened the healthcare system’s ability to respond to emergencies.

The report highlighted that McAllen recorded the highest uninsured rate in the state at 29.7%, followed by Laredo at 28.4%, and Brownsville at 26.7%. The data also showed that 70% of uninsured Texans are part of the workforce, yet still lack coverage. Among young adults aged 19–25, the uninsured rate was 28.5%, compared to only 14% nationally.

Texas’ Medicaid Gap Fuels Inequality

Researcher Divya Sangameshwar from ValuePenguin’s insurance research team said the high percentage of uninsured people creates a “vicious cycle” that leads to worsening health outcomes, higher medical debt, and lower economic productivity. She added that this gap deepens social inequalities and undermines the stability of the state’s healthcare system.

The report also revealed striking demographic disparities: 27% of Latinos in Texas are uninsured, compared to 15% of Black residents and just 9.9% of non-Hispanic white residents. Experts say these figures reflect a “coverage gap” faced by millions of workers who earn too much to qualify for Medicaid but not enough to afford private insurance or federal marketplace subsidies.

Analysts argue that Texas’ refusal to accept federal funding to expand Medicaid represents a major economic loss, as the state forgoes 90 cents in federal funding for every 10 cents it would have contributed. Experts stress that the result is widespread reliance on emergency rooms and urgent care centers—the most expensive and least efficient sources of care—raising costs for everyone and threatening family financial security.

Specialists warn that continuing this approach could worsen conditions in the long run, as the lack of insurance leaves families vulnerable to medical bankruptcy when facing health crises. This, in turn, hinders intergenerational wealth-building and deepens inequality in the state that has the highest number of uninsured residents in the U.S.