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Texas leads the country in the percentage of uninsured people

Courtney Collins
The Census Bureau reports that 18 percent of Texans are uninsured — the highest percentage in the nation.

Almost 1 out of every 5 Texans was uninsured in 2021. That's according to the Census Bureau’s 2021 American Community Survey 1-year estimates.

The census data, released this week, showed that 18% of Texans were uninsured in 2021. It was a very different story in Massachusetts, where 2 1/2% of the residents were uninsured.

Census Bureau officials say a number of factors influence whether a person has health insurance or not. But a key factor could be whether the state a person lives in expanded its Medicaid eligibility to lower-income families.

The census data shows that the five states with the highest uninsured rates did not expand its Medicaid eligibility. Texas leads that category followed by Oklahoma, Georgia, Wyoming and Florida.

A total of 36 states and the District of Columbia expanded Medicaid while 14 states have not.

The new data also reveals that a decline in the number of uninsured people across the country was driven by an increase in public coverage. Overall, 28 states saw a decline in the uninsured rate.

Got a tip? Email Stella M. Chávez at You can follow Stella on Twitter @stellamchavez.

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Stella M. Chávez is KERA’s immigration/demographics reporter/blogger. Her journalism roots run deep: She spent a decade and a half in newspapers – including seven years at The Dallas Morning News, where she covered education and won the Livingston Award for National Reporting, which is given annually to the best journalists across the country under age 35.