SPI Insights

For the second year in a row, Texas recorded the highest number of residents without health insurance out of all 50 states, according to a report released by the U.S. Census Bureau on September 10.

Texas topped the list at 17.7 percent, or 5 million people, without health insurance, according to the bureau’s “Health Insurance Coverage in the United States: 2018” report. The percentage of uninsured Texans increased from 17.3 percent, or 4.74 million people, in 2017, the bureau reported.

In general, the uninsured rate in states that expanded Medicaid eligibility was lower than in states that did not expand eligibility. In states that expanded Medicaid eligibility, the uninsured rate in 2018 was 6.6 percent, compared with 12.4 percent in states that did not expand Medicaid eligibility.

Last year, the uninsured rates by state ranged from Massachusetts’ 2.8 percent to Alaska’s 12.6 percent in the 31 expansion states, and from Pennsylvania’s 5.5 percent to Texas’ 17.7 percent in the 19 states that did not expand Medicaid eligibility on or before January 1, 2018.

Nationwide, 8.5 percent of Americans, or 27.5 million, did not have health insurance at any point of the year, an increase over 7.9 percent, or 25.6 million in 2017.

The 2018 data are based on the information collected during interviews between February and April last year for the Current Population Survey Annual Social and Economic Supplement (CPS ASEC) and American Community Survey (ACS).