Texans’ Healthcare Cost Struggles Outpace Nation’s: Survey

Data Journalist

Updated on September 16th, 2021

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Key Findings

Over half (52%) of Texans opted out of healthcare services over the past year, compared to less than half (46%) of all US adults

39% of Texan adults said it was because they couldn’t afford it, compared to 32% of national respondents

36% of Texan adults say they carry medical debt, compared to 28% of adults nationwide

21% of Texan adults lack insurance, compared to a national uninsured rate of 13%

Over half (52%) of Texans opted out of healthcare services as the COVID-19 pandemic raged over the past year.

HealthCareInsider asked Texan adults aged 18 and up if they avoided seeking healthcare services in the year since February 2020.

Dental (29%) and vision (24%) led the services that Texans opted out of. 19% of Lone Star State residents also passed on preventive health, and 11% stayed away from the emergency room.

Our nationwide survey in October 2020 showed that less than half (46%) of US adults had opted out of healthcare services in the past year (since October 2019).

Asked why they opted out of healthcare services, 39% of Texan adults said it was because they couldn’t afford it.

That’s seven percentage points higher than the 32% of national respondents who said they opted out of healthcare services in the past year because they couldn’t afford it.

“The reality is when you have a large uninsured population you’re going to see people avoid seeking healthcare due to cost,” says Timothy Callaghan, PhD, an assistant professor in the Department of Health Policy and Management at the Texas A&M School of Public Health.

“For the most part they seek out emergency room care, or some sort of clinic that accepts individuals without health insurance, which often results in very large out of pocket costs. The process becomes infinitely harder to navigate if you don’t have health insurance.” 

Meanwhile, 18% of Texans ranked medical bills as their number one healthcare expense, compared to only 15% of folks nationwide.

Prescription drugs are also among the top causes driving Texans healthcare cost struggles, coming in third after health insurance and medical bills.

11% of Texans ranked prescription drugs as their number one healthcare expense, compared to just 8% of respondents to our October nationwide poll.

Healthcare Driving Texans into Debt

Costly healthcare services are pushing Texans into debt.

36% of Texan adults say they carry medical debt, compared to just 28% of adults nationwide.

32% of Texans also stated they’d experienced a surprise medical bill in the past year.

Meanwhile, only 28% of national respondents said the same.

Pricy Health Insurance

Compared to Americans nationwide, more Texans can’t afford to buy health insurance.

58% of Texans who lack health insurance say it’s because they can’t pay for the coverage.

That’s five percentage points more than the 53% of US adults who say they’re uninsured because they can’t afford it.

Texas’ uninsured rate far surpasses the average found in our last nationwide poll.

HealthCareInsider’s October survey showed a national uninsured rate of 13%.

A staggering 21% of Texan adults lack insurance.

Texans also subscribe to national health insurance programs at far lower rates than people nationwide.

“Pundits have long hypothesized that Texas will turn purple but you’d have to have a blue legislature and receptive governor for a Medicaid expansion. I don’t see that happening given the many state representatives who oppose the Affordable Care Act.”

Timothy Callaghan, PhD, Asst. Prof., Dept. of Health Policy and Management, Texas A&M School of Public Health

Just 7% of Texans are on Medicaid, compared to 12% of respondents to our national survey.

Meanwhile, only 20% of Texans are signed up for Medicare, five percentage points less than the national rate of 25%.

Texas is one of 12 states that have not adopted the Medicaid expansion, and Callaghan says it’s not likely to change this position anytime soon.

“Pundits have long hypothesized that Texas will turn purple but you’d have to have a blue legislature and receptive governor for a Medicaid expansion,” he says.

“I don’t see that happening given the many state representatives who oppose the Affordable Care Act. Many legislators still see the ACA as something associated with Obama and many conservative Texans wouldn’t be happy with that.”

Methodology

All Texas-specific figures, unless otherwise stated, are from YouGov Plc.  Total sample size was 1038 adults. Fieldwork was undertaken between 26th February – 3rd March 2021.  The survey was carried out online. The figures have been weighted and are representative of all Texas adults (aged 18+).

All national figures, unless otherwise stated, are from YouGov Plc.  Total sample size was 1414 adults. Fieldwork was undertaken between 19th – 20th October 2020.  The survey was carried out online. The figures have been weighted and are representative of all US adults (aged 18+).



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