Poll shows uninsured Texans face far more difficult battle to access and afford basic medical care

53% of Texans say they skipped or postponed health care needs because of cost

Nearly half of all Texans say it’s difficult for them to pay for health care and 53% say they’ve skipped or postponed medical care because of cost. But Texans without health insurance face much more difficulty affording medical care and are far more likely to skip going to the doctor. Those are some of the findings from a statewide Episcopal Health Foundation (EHF) poll on affordability and access to health care in Texas.  

Researchers found that compared to health care, fewer Texans reported difficulties affording other basic necessities like rent or mortgage, monthly utilities, transportation costs, or food. The survey finds that 49% of Texans say that it’s difficult for them and their family to afford health care, with about one-quarter (24%) saying it’s “very difficult” to afford medical care. In addition, researchers found that one-third (33%) of Texans say they or someone in their household had problems paying medical bills in the past year.

But for uninsured Texans, the survey finds that it’s a far more difficult road. Researchers found that the vast majority (79%) of uninsured Texans under age 65 say paying for health care is difficult for their family, including 51% who say it’s “very difficult” to afford care. The statewide survey also finds that a majority of immigrants (82%), Hispanic residents (67%), and Black residents (57%) say it’s difficult for them to afford health care, compared to 37% of White residents who said the same.

“These numbers are just the latest confirmation that uninsured Texans continue to fight an uphill battle to afford and access even the most basic medical care,” said Elena Marks, EHF’s President and CEO. “The uninsured in Texas include workers at grocery stores, childcare centers, and construction sites. And their battle to pay for basic care isn’t just affecting their wallets, it’s having a direct impact on their health. Something has to change in Texas.”

When it comes to skipping health care due to cost, more than half of Texans (53%) say they or someone in their family skipped care – including checkups, tests, dental care, or filling prescriptions. Researchers found that two-thirds (67%) of Texans without health insurance and 65% of low-income families say they skipped or postponed care because they could not afford it.

In addition, the poll finds that 25% of Texans say they don’t have a usual place to go when they get sick or need care. Some Texans (5%) say they only use the emergency room for their medical care. Again, researchers found that finding places of care was harder for those without health insurance. The survey finds more than half (51%) of uninsured Texans and 45% of immigrant residents say they don’t have a usual place for care or go to the emergency room when they’re sick.


SSRS conducted the third wave of the Texas Health Policy Survey on behalf of Episcopal Health Foundation from November 30 through December 9, 2020. The goal of this survey was to understand the perspectives and experiences of Texas adults regarding their health care and health care affordability and access, with a comparison to similar studies completed in 2018 and 2019. For the 2020 survey, SSRS interviewed a representative sample of 1,204 Texas adults (age 18 or older). Interviews were conducted by live professional telephone interviewers in English or Spanish based on the respondent’s language preference.