NCPA - National Center for Policy Analysis

Many Texans Uninsured By Choice

March 5, 2001

The number of Texans without health insurance became an issue during the presidential campaign, and in fact, one in four Texans don't have insurance -- the highest percentage in the nation. But one reason the number is so high is that many Texas families that can afford it simply choose not to buy it.

This is because the lack of insurance is no barrier to health care.

  • Public and private organizations spend an average of $1,000 per uninsured individual on charity care each year.
  • That equals $4,000 for a family of four -- an amount that would buy adequate private insurance in most Texas cities.
  • There are more than 40 federal programs that fund health care for the uninsured in the state.
  • The largest program -- the disproportionate-share hospital payment program -- spends more than $1.5 billion a year to compensate hospitals that serve indigent patients.

The alternative to free care is purchasing private insurance. But most uninsured Texans get no government subsidy if they choose to buy coverage. Federal tax subsidies for employer-provided health care total about $125 billion per year, but the uninsured get virtually no tax relief when they purchase their own insurance with after-tax dollars.

A Blue Ribbon Task Force on the Uninsured recommended expanding enrollment in the Medicaid program, but several national studies show growth in public programs tends to be at the expense of private insurance, and the number of uninsured remains the same.

The best way to reduce the number of uninsured is to subsidize private insurance as generously as free care for the uninsured is subsidized.

Source: John C. Goodman (NCPA), "Why Do So Many Texans Lack Insurance?" Dallas Morning News, March 5, 2001.


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