Census Data Show TEXAS Stands To Gain Most From Health Reform
Article from : Center for Public Policy Priorties
For Immediate Release: 09/10/09
Contact: Derrick Crowe 512-320-0222, ext 112 or crowe@cppp.org
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CENSUS DATA SHOW TEXAS STANDS TO GAIN MOST FROM HEALTH REFORM
Austin, Texas – New data released today by the U.S. Census Bureau show that in 2008, Texas remained the state with the
highest uninsured rate in the nation with an uninsured population that now tops 6 million people. With so many Texans
lacking health security, Texas has more to gain than other states from national health reform legislation, which the
Congressional Budget Office projects will cover 94 percent of Americans under age 65.
Despite growth in the total uninsured population in Texas, the population of uninsured children actually declined. Children, like adults, continued to lose coverage through employer-sponsored insurance, but increased coverage through public programs like CHIP and Medicaid more than made up for that loss. Because Texas entered the recession later than the nation and still experienced low rates of unemployment through most of 2008, the 2008 data released today reflect little of the impact of the recession on Texas. Due to the steep rise in the state unemployment rate in 2009, Texas’ uninsured population is most likely even larger today than these latest 2008 estimates indicate. “It’s no surprise that Texas is still in last place in terms of health insurance coverage.
Texas stands to gain more than any other state from national health reform legislation. Not only will health reform help millions of uninsured Texans, the 18 million Texans with coverage today will benefit from more affordable options and peace of mind knowing that coverage will be available even if you lose or change your job and if you get sick, you won’t be denied care, lose coverage, or pay more for care,” CPPP Associate Director Anne Dunkelberg said.
The Texas Uninsured Rate is the Worst in the Nation
• U.S. Census data show that Texas remains the state with highest percentage of residents who lack health insurance—25
percent in Texas compared to the national average of 15 percent. In all, 6.1 million Texans were uninsured for the
entire year of 2008, an increase of about 122,000 individuals—enough people to more than fill UT’s Darrell K. Royal
Memorial Stadium—over the previous year’s Census estimate.
• If Texas could reduce its uninsured rate from 25 percent to 15 percent to match the national average, another 2.4
million people in Texas would be covered.
Texas Still in Last Place for Kids’ Coverage, but Improving
• Texas also remains in last place for coverage of children for the 10th consecutive year, with about 20 percent or 1.4
million children lacking insurance in 2008. Texas has more uninsured children than California (1.1 million) even
though California has more total children, because the uninsured rate for California children is nearly half that in Texas
(11 percent in California versus 20 percent in Texas).
• Despite growth in the total uninsured population in Texas, the population of uninsured children actually declined from
1.5 million to 1.4 million. Just like adults, children continued to lose coverage through employer-sponsored insurance,
but increased coverage through public programs like CHIP and Medicaid more than made up for that loss. Much of
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the increase in coverage is likely due to restorations in the CHIP program at the end of 2007. Enrollment in CHIP
grew from 349,000 in December 2007 to 455,000 in December 2008.
Texans Continue to Lose Job-based Health Insurance
• About 49.5 percent of Texans got health insurance coverage through their job, or a parent or spouse’s job in 2008. This
is down from 50.4 percent in 2007, and is a full 9 percentage points below the national average of 58.5 percent. (see
Figure 2).
• The percentage of Texans covered by job-based health insurance has declined from 57.4 percent in 2000 to 49.5 percent
in 2008. These declines happened before Texas started to see big job losses in 2009, so coverage through job-based
insurance is probably even lower today.
“Health insurance coverage through jobs continues to shrink in Texas as employers and workers struggle to afford premiums.
Today’s Census numbers show us that Texas families need action on health reform now,” CPPP Senior Policy Analyst Stacey
Pogue said.
Texas’ High Uninsured Rate Driven Primarily by U.S. Citizens
• Immigrants in Texas were uninsured at higher rates than U.S. citizens, but uninsured U.S. citizens are the primary cause
of Texas’ high uninsured ranking. Even if there were no non-citizens in Texas at all in 2008, Texas would still have had
the second worst uninsured rate in the country—and that is comparing Texas with no immigrants to all the other states
with immigrants still included in their rates.
• Non-citizens, both legal and undocumented immigrants, account for only one-fourth of Texas’ uninsured population
(see Figure 2). New Data Reflect Little of the Recession’s Impact
• Because Texas did not begin to experience a sharp increase in the unemployment rate until late in 2008, the increase in
Texas’ uninsured population reported today does not yet reflect the full impact of the current recession. From 2007 to
2008, the unemployment rate in Texas increased just one half of a percentage point, from 4.4 percent in 2007 to 4.9
percent in 2008. However, in just the first seven months of 2009, unemployment in Texas grew from 6.4 percent in
January to 7.9 percent in July, the most recent month available (see Figure 3). This sharp increase in unemployment in
2009 means that the 2008 data released by the Census today shows little of the impact of the current recession on Texas’
uninsured rate. The increase in the Texas uninsured population of 122,000 people in 2008 is likely dwarfed by what is
happening right now.
National Health Reform Will Benefit Texans
• With 25 percent of Texans of all ages uninsured, Texas stands to gain more than any other state from national health
reform legislation. The nonpartisan Congressional Budget Office projects that 94 percent of Americans under age 65
would be insured under the U.S. House of Representatives’ latest health reform bill. In Texas, that would translate to
roughly 4.5 million uninsured Texans gaining coverage.
For more information on how Texas will benefit from national health reform, see www.texasvoiceforhealthreform.org/wpcontent/
uploads/2009/09/what-is-in-it-for-texas-2-rev-9-3-09.pdf.
Upcoming Data Releases on Poverty and the Uninsured
• As noted, the U.S. Census March Current Population Survey (CPS) uninsured estimates are designed to count Texans
who were uninsured for the entire calendar year, and to be accurate at the national and statewide levels. Later this
month, the Census Bureau will release data from a different survey, the American Community Survey (ACS), which is
designed to capture Texans who were uninsured at the time of the survey (rather than for an entire year), and which can
provide insight into the large variations in uninsured rates across our state. For more information on how to use these
different data sources and how CPPP plans to analyze them, see
http://www.cppp.org/files/3/data_explanation_memo.pdf.
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Figure 1: Employer-Sponsored Coverage Declining in Texas and Nationwide, Even Before Recession

Figure 2: Texas High Uninsured Rate Driven Primarily by U.S. Citizens

Figure 3: Uninsured Rate Released Today Does Not Reflect the Full Impact of the Recession

Texas’ unemployment rate worsened significantly after the period captured by the new 2008 uninsured data, suggesting that
the uninsured rate today is likely higher. Texas’ unemployment rate averaged 4.9 percent in 2008. As of July 2009, it climbed
to 7.9 percent.
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