Texas has some of the Southwest’s widest racial and ethnic disparities in health care, with Hispanic residents experiencing particularly poor access, quality and health outcomes, according to a new Commonwealth Fund report.
The private, nonprofit health-policy foundation examined 24 measures using federal data primarily from 2023 and 2024. Researchers evaluated insurance coverage, affordability, preventive treatment, use of medical services and deaths from conditions that could have been prevented or treated.
The study found that racial and ethnic disparities persist in every state, but their severity differs significantly. States that have invested more heavily in insurance coverage, primary care and preventive services generally performed better across racial and ethnic groups.
Texas’ broader health system already ranks near the bottom nationally. The Commonwealth Fund’s 2025 state scorecard ranked Texas 50th overall. About 22% of working-age adults were uninsured, and 17.6% of adults reported skipping care because of cost in 2024—well above the national average of 12.4%.
Those barriers fall disproportionately on Hispanic Texans, who are more likely to work in jobs that do not provide insurance and may encounter language, transportation and provider-access obstacles. Texas also remains one of 10 states that have not expanded Medicaid eligibility under the Affordable Care Act.
The report cautions that racial disparities are not explained solely by income or insurance status. Differences can persist because of where people live, shortages of nearby providers, unequal treatment and delays in receiving follow-up care.
State officials have argued that Texas supports health care through targeted programs, including women’s health initiatives, children’s coverage and funding for hospitals that treat large numbers of uninsured patients. Critics say those programs do not provide the continuous coverage available through Medicaid expansion.
The report warns that recent federal changes to Medicaid and Affordable Care Act coverage could widen existing gaps. Its authors recommend strengthening primary care, protecting preventive services and making affordable coverage more widely available.
Guest:
David C. Radley Ph.D., M.P.H., is a senior scientist for the Commonwealth Fund’s Tracking Health System Performance initiative and director of data and analytics at the Center for Evidence-Based Policy at Oregon Health and Science University.
"The Source" is a live call-in program airing Mondays through Thursdays from 12-1 p.m.
Leave a message before the program at (210) 615-8982.
During the live show, call 833-877-8255 or email thesource@tpr.org.
This interview will be recorded live on Monday, June 15, 2026, at 12:00 p.m.
