Nearly a quarter of Dallas residents are uninsured, according to a study that measures uninsured rates across the country. The WalletHub study ranked Dallas as the large city (over 300,000 population) with the highest rate of uninsured residents. It was ranked 539 out of 548 of all cities included in the study, which analyzed Census Bureau data. North Texas neighbor Garland was the seventh worse overall. Out of the 10 least insured cities in the country, seven were from Texas.
Texas has long held the dubious distinction of being the state with the highest uninsured rate in the nation. The state is one of 14 that has resisted Medicaid expansion, which would increase the number of working poor who would have insurance and currently do not.
Dallas is also one of the more expensive place in the country, which is compounded by the high number of uninsured residents living here. Hospital leaders have said that these uninsured patients put off preventable care until something is wrong, and end up in emergency rooms with costly uncompensated care for hospitals to deal with.
The public charge rule, which would have gone into effect in October if it hadn’t been struck down by a federal judge, has also had an impact on the number of uninsured residents in Texas as families worry that signing up for Medicaid or other public aid may affect their status in the country. The new rule says that immigrants will be denied citizenship if they are likely to become completely dependent on government aid, and it has clouded that path to health insurance for many communities. Cities in Texas with large hispanic population in southern Texas such as Pharr, Brownsville, Laredo, McAllen were all in the bottom ten for health insurance nationwide.
Overall, 24.42 percent of Dallas residents are uninsured. While the study said that over a fifth of all Texas adults are uninsured, over 27 percent of adults are uninsured in Dallas. The study revealed large racial disparities in insurance rates. White people were uninsured just over 10 percent of the time, while black people were uninsured just over 20 percent. Hispanics were uninsured at a rate of nearly 38 percent. Low income households were uninsured over 30 percent of the time, and even higher income households were at 11 percent uninsured. Dallas was in the bottom fifth of all cities for all of those categories.
The Wallethub study ranked Texas dead last in insurance rates overall, for children, adults, low income residents, and high income residents. They were in the bottom ten for white, black, and hispanic residents as well. The national uninsured rate was 8.5% in 2018, up from from 7.9% in 2017, but in Texas the rate is 17.7 percent.
Texas neighbor Oklahoma is the second worst insured state in the country, with states in the south and mountain west rounding out the worst insured states.
Read the whole study here.