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Texas Has the Highest Share of Uninsured in the Country

The state outdistances all others with 16.6 percent of its population without health insurance. Nationally, 8 percent of people don’t have coverage, according to the U.S. Census Bureau.

Texas leads the nation in the share of its population that lacks health insurance, with 16.6% of people being uninsured.

The states with the next-highest uninsured rate are Oklahoma and Georgia, where 11.7% of people are uninsured, according to annual statistics. Nationally, 8% of people don’t have health insurance, per the U.S. Census Bureau’s American Communities Survey, released Thursday.

In Dallas County, 41.6% of foreign-born residents were uninsured, and 35.1% of Latinos of any race were uninsured.

The annual data gives insight into poverty, health care, education and more throughout the country. The one-year release tracks communities larger than 65,000 people, while five-year releases explore much smaller populations.

Texas also has the highest rate of uninsured children, with 11.2% of Texans under 18 lacking insurance. That’s more than double the national rate of 5.1%. Children under 6 years old in Texas are uninsured at a rate of 7.9% while 12.1% of children between 6 and 18 are uninsured.

In Dallas County, those numbers are even starker. Over 16% of children in the county are uninsured, including 17.7% of children between 6 and 18.

According to Georgetown University’s Children’s Health Care Report Card, “When children are uninsured, they are more likely to have unmet health needs and lack a usual source of care, diminishing their chances to grow into healthy and productive adults.”

Texas is one of 28 states that does not offer presumptive eligibility for children in Medicaid or the Children’s Health Insurance Program, and one of 11 states that has not expanded Medicaid eligibility under the Affordable Care Act.

In addition, Texas has dropped 500,000 people from Medicaid after pandemic-era continuous enrollment expired in March, meaning even more Texans could be uninsured by next year’s survey. However, in the latest legislative session, Texas passed a measure extending Medicaid for pregnant women to a year after birth from the previous two months.

The census data showed that official poverty measures nationwide remained stable since last year’s report. New additions to the survey for 2022 reveal concerning statistics about housing and the gender pay gap in Texas and Dallas-Fort Worth.

Poverty rates, which are based on pretax income, showed minimal change from 2021 to 2022 in Texas and D-FW, which encompasses 11 North Texas counties.

In Dallas County, 14.2% of residents fell below the poverty line, compared to 14.3% last year, both figures coming within a few tenths of the rates for Texas as a whole. The national rate in 2022 was 12.6%.

Meanwhile, Collin County had a 4.6% poverty rate, while Denton and Tarrant counties had rates of 8.2% and 10.6%, respectively.

The poverty rate for children under 18 years of age was 19.2% statewide, 20.4% in Dallas County and 16.3% nationally, consistent with last year’s rates.

However, according to a census bureau report on poverty released Tuesday, child poverty rates rose dramatically nationwide when considering things beyond pretax income, such as noncash benefits and geographic variation in housing cost. This is quantified in a measure called the Supplemental Poverty Measure.

SPM rates rose across the board, but it increased the most among children, jumping from 5.2% in 2021 to 12.4% in 2022. Last year’s number represents a return to pre-pandemic rates, with the 2019 rate being 12.6%, according to the report.

The increase in child poverty was, “driven in part by the expiration of the expanded refundable tax credits and stimulus payments,” the report said.

Median household income in Texas rose from $66,963 in 2021 to $72,284 in 2022, though the census bureau does not consider this statistically significant when accounting for inflation.

Collin and Denton counties both had median household incomes above $100,000 while Dallas County came in at $70,852.

White people in Dallas County drew in $90,270 to Black people’s $51,176. Black people in Dallas County made around $5,000 less than Black people across Texas. Dallas County Latinos of any race made $64,021.

When broken down by gender, women over 16 years old nationally had median earnings of $51,275, or 82.2% that of men’s median earnings of $62,344. The gap, which existed in all demographics and education levels, was even wider among white people and among bachelor’s degree holders. Still, while white women made significantly less than white men, they made more than Black and Latino men.

In Dallas County, men with bachelor’s degrees made 38% more than women with the same degree, with median earnings totaling $92,358 to women’s $67,045. In Collin County, that gap stretched to nearly 70%, as men earned $114,800 while women’s earnings were comparable to those of their Dallas County counterparts.

The gap across D-FW far outpaces the gap nationwide, buoyed by large gaps in Collin, Denton and other wealthy counties. Nationally, men with bachelor’s degrees earned 41% more than women, but in D-FW they made nearly 53% more.

This is consistent with trends over many years, said Emily Martin, vice president for education and workplace justice at the National Women’s Law Center. She explained that in occupations that don’t require a degree, the ceiling for how much someone can be paid is relatively low, so there is only so much more a man can make than his female counterparts. However, salaries at the highest education levels are inflated, leading to wider gaps.

“High earners are mostly men, and the high earners are earning so very much,” she said.

New to this year’s ACS report are breakdowns of earnings by field of degree. While men in all fields made more than their female counterparts, the gap in D-FW was widest between men and women with business degrees and narrowest between those with education degrees.

Personal finance experts recommend not spending more than 30% of one’s income on housing.

However, for Dallas County, 48% of households devote over 30% of their income to rent, and 23.9% of tenants spend over half of their income in rent.

These numbers are near the national trends, where 46.2% of households spend over 30% of income on rent, and 24% of households devote over half of their income to rent.

The ACS tables released Thursday include, for the first time, detailed tables that show housing costs as a percentage of household income, a commonly requested statistic, said Evan Brassell, assistant division chief of the Census Bureau’s housing statistics branch.

“For example, in Texas, they have more than 980,000 households who are paying more than 50% of their income towards housing costs,” he said.

This is due to rising rents over the last decade and wages that haven’t kept pace, according to Cullum Clark, the director of the Bush Institute-SMU Economic Growth Initiative.

“The fastest price increases have actually taken place within the city of Dallas, but in relatively lower-income parts of the city of Dallas,” he said.

If this trend continues, Dallas is at risk of losing its affordability edge over other major cities, a benefit Dallas has long relied on for migration into the city. More and more people could also be pushed toward the suburbs, he said.

At the individual level, being “housing cost burdened,” the term for people who spend more than 30% of their income on housing, has many negative consequences.

“You start cutting back on food, health care, child care, if you can. Transportation becomes an issue,” said Ashley Brundage, executive director of housing stability for United Way of Metropolitan Dallas. “It puts people really in a very precarious position as far as just being one crisis away from losing their home.”

©2023 The Dallas Morning News. Distributed by Tribune Content Agency, LLC.
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