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Texas State Snapshot

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Explore the changing landscape of health coverage in Texas under the Affordable Care Act.

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TEXAS

TX

2015 Estimated Uninsured Rate of 18 to 64 year olds:
2013 Estimated Uninsured Rate of 18 to 64 year olds:
Decrease from 2013 to 2015:

16.0%
21.3%
5.3%

Before the first Affordable Care Act enrollment period began, Enroll America and Civis Analytics used sophisticated data targeting techniques to create a model of the uninsured population in America.
Over the last three years, this model has proven to be timely and accurate, and has played a critical role in our ability to understand who and where the uninsured are and get them the help they need
to enroll in coverage. This year, the model has been updated and was used to estimate insurance status for over 180 million non-elderly adult Americans. Grouping individual-level estimates by
geography, race, age, gender, and other characteristics enables us to understand the landscape of the uninsured population across the country. Here we provide a detailed look at the uninsured
population in Texas, put into context by plan selection data from HHS and a comparison with nationwide uninsured rates. All uninsured rates listed in this document are based on the Enroll
America/Civis Analytics uninsured model.
Chart 1: Texas Uninsured Rates for 2013 and 2015 of Key Demographic Groups

Overall

35

Race

Uninsured Rate

30

32

25

27

20
15
10
5

Age

Gender

16

27
23

21

23

22

20

19

21

15

13

13

11

17

17

16

16

2013

21
17

15

14

2015
12

0
National

Texas

Black

White

Hispanic

Asian

Male

Quick Summary

Female

18 - 34

35 - 44

45 - 54

55 - 64

State Map: 2015 Uninsured Rates by County

● The current uninsured rate in Texas is 16%. This has decreased by 5%
since 2013 prior to the first open enrollment period.
● 23% of Hispanics in Texas are uninsured, 19% of African-Americans are
uninsured and 22% of young adults (ages 18-34) are uninsured.
Targeting Recommendations
● Geographic - More uninsured people live in Harris County (16% of the
uninsured population) and Dallas County (10% of the uninsured
population) than any other county.
● Geographic - The counties with the highest uninsured rates currently
are Starr County (34%), Presidio County (34%), Hidalgo County (33%) and
Hudspeth County (32%).
● Demographic - Hispanic men ages 18 to 34 (32%) have the highest
2015 uninsured rates, followed by Hispanic women ages 18 to 34 (28%)
and African American men ages 18 to 34 (28%).

Map Scale: Uninsured Rates per County

10%

5%

15%

20%

Table 1: Distribution of Uninsured Population by Demographic Groups in Quick Summary
Race [1]
Distribution of Uninsured Population,
Ages 18 to 64
% 2013 Uninsured Population in Texas
% 2015 Uninsured Population in Texas
Change from 2013 to 2015

Gender

Age

Black

White

Hispanic

Asian

Male

Female

18 - 34

35 - 44

45 - 54

55 - 64

7.7%
6.6%
-1.1%

49.1%
49.7%
0.6%

40.8%
41.2%
0.4%

2.4%
2.5%
0.1%

50.5%
50.0%
-0.5%

49.5%
50.0%
0.5%

31.9%
36.3%
4.5%

21.8%
18.3%
-3.5%

30.1%
27.7%
-2.3%

16.3%
17.6%
1.3%

Table 2: 2015 Uninsured Rates in Most Populous Counties
Total
Top 10 Most Populous Counties,
Ordered by Population Size
###
###
###
###
###
###
###
###
###
###

Harris County
Dallas County
Bexar County
Collin County
El Paso County
Denton County
Fort Bend County
Cameron County
Galveston County
Brazoria County

Race

Gender

Age

Percent

2015
Uninsured Rate

Black

White

Hispanic

Asian

Male

Female

18 - 34

35 - 44

45 - 54

55 - 64

16%
17%
15%
7%
25%
9%
11%
30%
13%
13%

20%
19%
17%
9%
21%
11%
14%
26%
17%
13%

12%
13%
11%
7%
20%
8%
9%
22%
11%
11%

22%
23%
19%
12%
27%
14%
16%
31%
18%
18%

15%
15%
12%
7%
21%
9%
10%
24%
12%
10%

17%
18%
16%
8%
27%
9%
11%
32%
14%
14%

15%
16%
14%
7%
24%
8%
10%
28%
12%
12%

22%
22%
21%
12%
33%
14%
16%
39%
18%
19%

14%
15%
13%
6%
22%
7%
10%
27%
11%
11%

16%
16%
14%
6%
23%
7%
9%
28%
11%
11%

12%
13%
12%
5%
20%
6%
8%
24%
10%
10%

Page 1 of 2 - Texas State Snapshot - Enroll America - October 2015

% of TX
Uninsured
Population
16%
10%
7%
2%
5%
2%
2%
3%
1%
1%

www.enrollamerica.org

0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0

TEXAS

TX

OE2 Plan Selection Data from Health and Human Services

Remaining Uninsured Estimates from June 2015 Kaiser Family Foundation Study

Total OE2 Plan Selections in Texas: [2]
Effectuated OE2 Plan Selections: [3]
% Effectuated of Total Plan Selections
Texas plans with Advanced Premium Tax Credit (APTC):
% APTC of Effectuated Plans

1,205,174
966,412
80%
832,334
86%

Estimated Number of Remaining Uninsured in Texas: [4]
% Medicaid Eligible of Remaining Uninsured
% Tax Credit Eligible of Remaining Uninsured
% Ineligible for Financial Assistance of Remaining Uninsured [5]
% Consumers in Coverage Gap of Remaining Uninsured

4,425,000
11%
23%
48%
17%

Chart 2: Distribution of Total Plan Selections by Provided Age and Race [6,7]
Distribution of Plan Selections by Age
0%

10%

20%

30%

40%

50%

60%

70%

80%

Distribution of Plan Selections by Race [6]
90% 100% 0%

20%

40%

60%

80%

100%

Texas
Harris County
Dallas County
Bexar County
Collin County
El Paso County
Denton County
Fort Bend County
Cameron County
Galveston County
Brazoria County
18-25

26-34

35-44

45-54

55-64

White

Latino

Black

Asian

Other

National Map: 2015 Uninsured Rates by County

● In 2013 before the first open enrollment period, Texas's uninsured rate of 21.3% was 4.9% greater than the national uninsured rate.
● In 2015, Texas's uninsured rate of 16.0% is 5.3% greater than the current national uninsured rate.

State Comparison with National Uninsured Rate
25

Uninsured Rate

20
15

21.3
16.4

10

16.0

2013
2015

10.7

5
0
National

Texas

Map Scale: Uninsured Rates per County

0%

5%

10%

15%

20%

Footnotes
[1] Civis Analytics uses a similar scoring method to assign most likely race to consumers which explains why the race distribution adds up to 100%.
[2] March 10, 2015 ASPE Issue Brief with total plan selections by state from from November 15, 2015 to February 22, 2015. Full memo can be found here:
http://aspe.hhs.gov/sites/default/files/pdf/83656/ib_2015mar_enrollment.pdf
[3] March 31, 2015 Effectuated Enrollment Snapshot released by the Department of Health and Human Services (HHS) on June 2, 2015. This includes all new and renewing consumers during the second
open enrollment period from November 15, 2015 to February 22, 2015. Additional information can be found at: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Factsheets-items/2015-06-02.html
[4] Estimates of Eligibility for ACA Coverage among the Uninsured released by the Kaiser Family Foundation on June 1, 2015. Additional data and methodology can be found at:
http://kff.org/uninsured/issue-brief/new-estimates-of-eligibility-for-aca-coverage-among-the-uninsured/
[5] Ineligible for Financial Assistance is due to Income, ESI Offer, or Citizenship.
[6] HHS released county level plan selection data broken down by age and race, among other groupings. These plan selections include all new and renewing consumers during the second open
enrollment period. The full data file can be found at: http://aspe.hhs.gov/basic-report/2015-plan-selections-county-health-insurance-marketplace
[7] Enrollments for which race is unknown was not included in this graphic. This varies between states, but 36% of plan selections had an unknown race. Other includes American Indian/Alaska Native,
Native Hawaiian/Pacific Islander and Multiracial.

Additional Enroll America Research, Blogs and Maps can be found at :
https://www.enrollamerica.org/research-maps/
Page 2 of 2 - Texas State Snapshot - Enroll America - October 2015

www.enrollamerica.org

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