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Uninsured rate is also bigger in Texas

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Selling health insurance in Texas may be especially challenging.

Analysts at the Commonwealth Fund have published data supporting that conclusion in a summary of results from a health coverage trends survey.

The think tank hired a firm to conduct a national telephone survey from July 2014 through December 2014, and extra surveys of California, Florida, New York and Texas from July through December 2014.

California and New York set up state-based Patient Protection and Affordable Care Act (PPACA) exchanges and took PPACA Medicaid expansion money.

Florida and Texas have opposed PPACA. They refused to set up PPACA exchanges or expand their Medicaid programs. The U.S. Department of Health and Human Services (HHS) is running the exchange programs in Florida and Texas through the HealthCare.gov system.

The Commonwealth Fund analysts did not adjust the data for income level, or provide any data showing how uninsured rates or other indicators have changed over time, but they did report that the overall U.S. uninsured rate for adults ages 19 to 65 who participated in the survey was 16 percent.

The uninsured rate for the survey participants was 12 percent in New York, 17 percent in California, 21 percent in Florida and 30 percent in Texas.

Review of the Texas data shows that uninsured rates were much higher in Texas for every demographic subgroup, and that the gap was worse for the highest-income Texans than for other lower-income Texas.

When the analysts broke the adult uninsured rate down by income, for example, they found that the U.S. uninsured rate was 27 percent for people with income under 100 percent of federal poverty level (FPL), 16 percent for people with income of 100 percent to 399 percent of FPL, and 3 percent for people with income of 400 percent of FPL or higher.

In Florida, the comparable percentages were a little higher. There, the uninsured rate was 33 percent for low-income residents, 22 percent for middle-income residents, and 4 percent for high-income residents.

In Texas, the uninsured rate was 51 percent for low-income residents, 28 percent for middle-income residents — and 7 percent for high-income residents.

In other words: low-income Texans were about 66 percent more likely to be uninsured than middle-income Florida residents, and middle-income Texans were about 33 percent more likely to be uninsured than middle-income Florida residents.

See also: Health costs slam middle-income Americans

High-income Texans were 75 percent more likely to be uninsured than high-income Florida residents, and more than twice as likely to be uninsured than high-income Americans as a whole.

Texans also reported having worse access to health care, but the health care access gap was smaller than the uninsured rate gap.

About 43 percent of Texans reported having some kind of cost-related access problem in the previous 12 months, compared with 43 percent of the Florida residents and 36 percent of all U.S. residents.

See also: 5 rich countries where it’s hard to see a doctor

The analysts did not break the care access data in the states down by insured states or income level.