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Comptroller's Desk
Too Many Uninsured Texans

As Texas Comptroller, I am charged with supervising and managing all of the state's fiscal concerns. The lack of adequate and affordable health care in Texas is a critical burden that affects all of us--families, taxpayers, businesses, health care providers, state and local governments, and our most precious resource, our children.

According to the U.S. Census Bureau, Texas has the highest share of uninsured persons of any state. Based on the most recent data available, about one in four Texans lacked health insurance at some point. The U.S. average for the same period was more than one in six Americans. In fact, every major metropolitan area in Texas exceeds the U.S. average.

The Laredo and El Paso metropolitan statistical areas had the state's highest share of uninsured residents, at 36 percent and 33 percent, respectively. Brownsville-Harlingen-San Benito had 32 percent uninsured; Corpus Christi, 28 percent; and McAllen-Edinburg-Mission, 28 percent.

Among the largest metropolitan areas, Houston led with almost 28 percent of its residents lacking health insurance. In Dallas, the uninsured rate was 25 percent; in San Antonio, 24 percent; and in Fort Worth-Arlington, 24 percent. Austin had the lowest share among largest cities, at 18 percent, but that still exceeded the national average.

The sheer number of uninsured Texans ultimately makes health care less affordable for Texas employers and individuals alike. Much of the costs involved in providing health care to the uninsured ultimately are shifted to those who have health insurance--and to Texas taxpayers.

I have previously suggested ways in which the federal and state governments could help more Texans afford health insurance. Some of these have been enacted, such as a program that allows small businesses to form cooperatives to purchase affordable employee health insurance.

I firmly believe that the next step is to fully restore the cuts made in 2003 to the Children's Health Insurance Program (CHIP). As of May 2005, 180,450 children have been dropped from CHIP. That is a 35.6 percent drop. These children don't simply disappear; they turn up in local emergency rooms.

Recently, the Legislature voted to restore dental, vision, mental health and hospice benefits to CHIP. That is a good step, but we must restore the eligibility requirements that will make these benefits available to more Texas children.

Tackling the health insurance problem will require innovative ideas and actions. This is a challenge for all Texans. Texas is great, but we can do better.

Carole Keeton Strayhorn
Texas Comptroller