Before the ACA was implemented, according to U.S. Census data, Texas had the highest uninsured rate in the country in 2013 (22.1 percent). It’s gone down since then, but Texas still had the highest uninsured rate in 2018, at 17.7 percent.
Texas leaders have been vocally opposed to the ACA, and the state has thus far refused to expand Medicaid, so a cornerstone of the law’s ability to reduce the uninsured rate is unavailable in Texas.
But more than a million Texans are enrolled in private health plans through the exchange, and 92 percent of them are receiving premium subsidies that average $468/month and make their monthly health insurance premiums more affordable. And 60 percent of them are receiving cost-sharing reductions, which make their out-of-pocket healthcare expenses (deductible, copays, coinsurance) less costly.