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Expanding Health Insurance In Texas Can Positively Impact Our Health And Economy

Access to health services is vital to advance health equity in our community


The primary reason for expanding access to health insurance is the wellbeing of Texans. At the same time, however, such efforts can have a substantial positive impact on the state’s economy.

The Issue:

Millions of our state’s most vulnerable populations do not have health insurance    more than double the national average. Further, an estimated 54% of Austin area residents making less than $55,000 a year do not receive paid sick leave benefits. These issues have almost certainly worsened due to COVID-19 and the related economic fallout and job losses. 

Currently, Texas is one of only 12 states that have not yet chosen to expand health insurance coverage to low-income adults. While the primary reason to expand health insurance is human health and wellness, providing adequate resources for health insurance also makes economic sense. According to a recent study of Texas’ Medicaid coverage, an estimated 954,000 newly eligible adults would enroll in insurance coverage if an expansion were available, bringing approximately $5.41 billion in federal dollars annually to the state.  

The Findings: 

This report from The Perryman Group demonstrates how Texas could alleviate problems caused by the state’s uninsured rate by expanding health insurance coverage using available federal funds, as well as benefit from notable economic gains. 

In addition to enhancing the health and wellbeing of those who receive insurance coverage, expanded coverage contributes to fewer emergency room visits, improved health outcomes, enhanced employment and productivity, reduced morbidity and mortality, and reduced costs of uncompensated care, among other beneficial outcomes. 

Over the next 10 years, the benefits of implementing expanded health insurance coverage become clear, with estimates increasing to $244.7 billion in output, $158.9 billion in personal income, and well over 2.1 million job-years of employment. A breakdown of the economic benefits is as follows:

Return on investment for health insurance expansion. Research in association with St. David's Foundation

Perryman Group
Episcopal Health Foundation

Across our goals and principles, St. David’s Foundation is guided by its commitment to advance health equity and believes all people should be able to easily access the care they need when they are sick or need medical attention. It is this belief that drove the Foundation to partner with Episcopal Health Foundation to support The Perryman Group to better understand how the expansion of health insurance for some of Texas’ most vulnerable populations would impact access to care and thus improve the lives of individuals and families.

Meet our Contributors


Amy Einhorn, MPP

Senior Program Officer