💡 What’s Happening?
Poor health outcomes don’t exist in a bubble. They’re often the result of compounding barriers that eventually lead patients to a hospital bed.
Texas is facing a growing healthcare access crisis. Rising costs, shrinking affordability and coverage instability are making it harder for Texans to seek care when they need it most.
As patients delay treatment, hospitals must manage more severe illnesses, longer stays and higher uncompensated costs while already operating under financial strain.
“Higher insurance premiums, higher costs of procedures and less community access to providers and procedures occur when areas have more uninsured people.”
(How equitable is Texas health care? New report shows gaps, Austin American-Statesman)
“The high cost of medical care leads many to skip or postpone getting the healthcare they need. Overall, almost two-thirds of Texas adults have skipped or postponed some sort of healthcare because of the cost (63%) in the past 12 months.”
(Texans’ Experiences with Health Care Access and Affordability, Episcopal Health Foundation (2024 Report))
🔍 Patient POV
- Price Tag Anxiety – When Americans think about the future of their health, the top three concerns are difficulty paying medical bills, delaying care due to cost and being unable to afford health insurance.
- Remember the EPTCs? Enhanced Premium Tax Credits (EPTCs), which expired late last year, helped drive record Affordable Care Act enrollment in Texas. Roughly 95% of Texas Marketplace enrollees relied on those subsidies to reduce monthly premiums. Without them, annual out-of-pocket premium costs are expected to rise by more than $700 for many Texans, and approximately one million Texans could lose coverage by 2034.
- Hidden Drawbacks – Pharmacy discount programs and alternative payment models may lower upfront costs for consumers, but they also create unintended consequences with insurance companies – including higher premiums.
“I think there’s going to be a lot of folks, particularly in the Dallas area, that are really going to struggle with these increased premium amounts. We’re probably not even fully understanding that just yet because of how complicated this is.”
(North Texas doctor explains effects of ACA tax credits expiring, Fox4 News)
“Manufacturers issue the coupons to keep their drugs competitive by offering patients short-term savings. Consumers pay less out-of-pocket, often for brand-name drugs. This encourages patients to use the brand-name version of the drug, even when a cheaper, generic version might be available.
Some insurers say this unfairly puts them on the hook for pricier drugs. They say monthly premiums are higher as a result, punishing consumers and patients, not the manufacturers.”
(That discount at the pharmacy counter may pack hidden costs, Fort Worth Star-Telegram)
🎯 Why It Matters
When patients postpone care due to affordability concerns, they often arrive sicker and require more costly, intensive treatment. Plus, they often stay in the hospital longer.
Many patients leave with medical bills they struggle to pay, contributing to uncompensated care costs that hospitals must absorb. Texas hospitals are already navigating rising operational expenses, staff shortages and limited inpatient capacity. The result is a cycle where barriers to affordable care place greater pressure on an already strained healthcare system.
❤️ A Lone Star State of Caring
Texas has the highest uninsured rate in the nation, and Texas hospitals are the last line of defense for those who can’t afford primary or preventative care. Not if, but when conditions become severe or life-threatening, hospitals deliver emergency, acute and essential care regardless of a patient’s ability to pay, reinforcing the safety net for millions of Texans.
Through community benefits, nonprofit hospitals invest directly into the health of their communities through programs like free vaccinations, chronic disease management, affordable medications and charity care, or discounted or free care for patients unable to pay. These services are built around identified local health needs and aim to improve prevention, expand access and reduce avoidable hospitalizations.
And Texas non-profit hospitals continue to step up:
- Texas has one of the nation’s strongest charity care laws, and Texas hospitals provide billions of dollars above the minimums required by law.
- $14.9 billion in total community benefits provided ($19 in community benefits for every dollar in tax benefit received)
- $3.4 billion in unreimbursed charity care ($11.40 in unpaid care for low-income Texans for every dollar in tax benefit received)
Texas non-profit hospitals remain among the nation’s leaders in community investment and charity care, helping bridge the widening gap between Texans and the care they need.
Learn more about the stellar community benefit work in Texas hospitals.
⭐ Affordability is access.
Policies that strengthen coverage and reduce costs help patients seek care earlier, improve health outcomes and ease pressure on hospitals working to care for every Texan who walks through their doors.
📖 Learn More
Charity Care and Community Benefits
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