Once again, Texas has the nation's highest rate of people without health insurance.

About 24.6 percent of Texans, in a three-year average ending last year, were uninsured, according to 2003 data on health insurance, income and poverty released Thursday by the U.S. Census Bureau.

Experts say Texas' stringent Medicaid eligibility requirements and heavy migrant population, as well as more employers dropping coverage, contribute to the state's high rate.

New Mexico , at 21.3 percent, was the only other state where more than a fifth of residents lacked health insurance.

The percentage of uninsured Texans, calculated in two-year averages ending last year, rose to 25.2 percent, from 24.7 percent in 2001-2002. Nationwide, about 15.6 percent of residents were uninsured in 2003, up from 15.2 percent a year earlier, largely due to more employers dropping health benefits.

About 45 million people in the United States didn't have health insurance. A decrease in employer benefits was partly offset by an increase in the number of people covered by government programs in 2003, mostly Medicare for the elderly and disabled and Medicaid for the poor.

Some noted that the number of people with health insurance actually rose to 243.3 million from 242.4 million in 2002.

"The portion of people without insurance is pretty stable over a decade, and the population has also increased," said Devon Herrick, a health care analyst with the National Center for Policy Analysis in Dallas.

Lisa McGiffert, a health care analyst with Consumers Union in Austin, noted that the data offered further evidence that current trends "will not get us to universal coverage."