Medicaid expansion remains on hold in Texas as state struggles with medical debt, high uninsured rate

The country’s medical debt crisis is at its most dire in several parts of Texas, which is home to three of the worst 10 U.S. counties for medical debt, according to data analyzed by the Urban Institute.

In each of those communities — Haskell County, Pecos County and Nolan County — the share of residents with outstanding delinquent medical bills is at least three times as high as the U.S. average.

In Haskell County, 43% of residents have medical debt that’s gone to collections, a rate that’s higher than almost anywhere else in the country. The Pecos and Nolan County rates are within a few percentage points, hovering around 40%.

Experts say medical debt is so pronounced in Texas because of the high number of uninsured people. More than 5 million Texans are uninsured, according to the U.S. Census Bureau, or about one in five Texans. That’s much higher than the overall U.S. uninsured rate of 8%.

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“There is absolutely no doubt that the people with the highest risk of medical debt are the uninsured,” said Anne Dunkelberg, associate director with the public policy institute EveryTexan, who has studied medical

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