Of the more than four and a half million uninsured children in America, almost a quarter of them call Texas home. That’s according to a new report by Georgetown University. As Texas Public Radio reports, Texas saw the largest increase in the rate of uninsured children between 2022 and 2024, from 10.9% to 13.6%, a new total that is more than double the national average and the highest total in the country. In sheer numbers, that translates into 1.1 million kids in Texas who find themselves uninsured. Joan Alker is executive director of the Georgetown Center for Children and Families.
Alker says one major factor to help explain why so many children are uninsured is how the state of Texas handled the end of continuous Medicaid coverage after the COVID-19 public health emergency ended. “If all states had done as poorly as Texas did with the unwinding, we would have seen a much higher jump in the uninsured rate of children nationally.”
During that unwinding period in 2023, states were tasked with checking recipients’ eligibility. And across the country nearly 15 million people fell off the Medicaid rolls, about one-third of whom were kids. That process, in turn, increased the national percentage of uninsured children from 5% to 6%, according to analysis by Georgetown researchers using U.S. Census Bureau’s Community Survey. In Texas, disenrollment came to 1.8 million recipients.
Lynn Cowles is with the research and advocacy group Every Texan. She says many more kids are at risk of losing their coverage due to changes in the federal budget bill. Cowles says more than half a million Texas children are enrolled in the federal Health Insurance Marketplace. “These are the middle-income families, who will really, really get hit by the expiration of the enhanced advanced premium tax credits.”
That tax credit was designed to make Affordable Care Act (ACA) coverage more affordable. Cowles says the risk extends to adults with ACA coverage and people enrolled in Medicaid plans.
