A new survey reveals Texans are struggling to pay healthcare costs

Many Americans struggle to pay for healthcare costs. But Texans have been hit especially hard.

Texas made news before the pandemic for having one of the worst healthcare systems in the country. And it appears things haven’t improved since then.

Lone Star State residents say that the cost of medical bills, health insurance, and prescriptions are a significant drain on their wallets.

More than half (52%) of Texans opted out of healthcare services during the COVID pandemic, compared to less than half (46%) of all U.S. adults.

The most commonly-skipped services were dental (29%) and vision (24%) appointments. However, preventive (19%) and emergency care (11%) also topped the list.  

There are a couple of reasons why more Texans may be opting out of healthcare. 

1. Higher healthcare costs

Of those who passed on healthcare in 2020, 39% of Texans said they couldn’t afford it. That’s compared to 32% of national survey respondents. 

It doesn’t help that Texas has the most expensive hospital bills in the nation: The Texas Observer reports that prices before insurance were 6.4 times higher on average than the price allowed by Medicare in 2018. 

Areas along the Texas-Mexico border are most affected by high hospital rates. 

As such, it’s unsurprising that adults in Texas carry more medical debt than people in other states: 36% versus 28%.

2. Fewer have insurance

Twenty-one percent of Texans are uninsured. That’s eight percentage points higher than the national rate. 

Among uninsured Texans, 58% say that health insurance is out of reach, compared to 53% of U.S. adults.

One reason could be that Texas is one of 12 states that hasn’t expanded Medicaid offerings under the Affordable Care Act (ACA). 

Before the ACA, you could qualify for Medicaid only if you belonged to these low-income groups:

• The elderly
• People with disabilities
• Children
• Pregnant women

However, the ACA expanded Medicaid coverage to include those with incomes up to 138% of the Federal Poverty Level. (That’s $17,609 for an individual in 2020.) 

According to the Kaiser Family Foundation, more than 1.4 million uninsured adults could get coverage if Texas expanded Medicaid. 

Expanding coverage may only be one option or a first step. As Charles Liu, M.D., told NPR, the current healthcare system still leaves out a lot of people, and “we still have a lot more work to do – more and more reform is needed, more innovative ideas and more support.”