A found that Texas has more severe racial and ethnic health disparities than other states in the Southwest.
Hispanic people experienced the worst health outcomes, access and quality in Texas, according to a new report from the 鈥� a private foundation focused on health equity in the U.S. The report notes that racial and ethnic health disparities 鈥減ersist across every state鈥� and may worsen as recent policy changes take hold.
鈥淚n most states, American Indian and Alaska Native people and Black and Hispanic people and communities really continue to bear the highest burden and have the worst health access and affordability,鈥� said Dr. Laurie Zephyrin, senior vice president for Achieving Equitable Outcomes at the Commonwealth Fund.
The report also finds that these populations are more likely to die from 鈥減remature and avoidable deaths鈥� 鈥� while being less likely to have health coverage.
Researchers analyzed the most recent state data available on 24 measures related to health care access, quality and use of services and health outcomes to produce the state-by-state report. Based on that performance data, the report evaluates differences across racial and ethnic groups both within and between states.
鈥淭he Hispanic population had some of the lowest scores achieved in the report, particularly in a handful of southern and southeastern states, including Arkansas, Georgia, Oklahoma, and Texas,鈥� said Kristen Kolb, a research associate for the Commonwealth Fund.
She said the Hispanic population tended to be among the lowest performance on measures of affordable access to care.
鈥淲hen health services are not affordable, people are more likely to forgo needed care,鈥� Kolb said.
Nationally, the report shows the rate of people skipping care because they can鈥檛 afford it is increasing 鈥� after hitting historic lows in 2021 and 2022. Hispanic and American Indian and Alaska Native communities saw the steepest increases.
In all but seven states, Hispanic adults were the most likely to go without care they couldn鈥檛 afford 鈥� and in most states, they were also the most likely to lack a regular source of care.
Among the 48 states the report was able to rank and the District of Columbia, Texas ranked 45th for health system performance for the Hispanic population 鈥� just ahead of its neighbors, Oklahoma, which ranked 46th, and Arkansas, which ranked last.
However, the authors of the report highlight that the most recent data doesn鈥檛 account for several factors that will likely worsen health disparities 鈥� including federal and state policy changes targeting social service programs, like Medicaid and the Supplemental Nutrition Assistance Program, or SNAP.
In addition to funding cuts and tightened eligibility requirements, there are new restrictions that will bar 鈥渕ost legal immigrants and asylees from [federal healthcare] marketplace and Medicaid Coverage.鈥�
Advocates in Texas have raised concerns about Texas鈥� high uninsured rate 鈥� the . There are more than 1 million uninsured children in the state, which is more than 13% of the total population of Texas children. Unidos, the nation鈥檚 largest Hispanic civil rights and advocacy organization, published a report in February that found two-thirds of Texas鈥� uninsured children are Latino.
The data is also from before the enhanced premium tax credits for Affordable Care Act, or ACA, marketplace coverage expired at the beginning of 2026 鈥� causing premiums to more than double for most ACA enrollees.
In 2025, Texas has more than four million people enrolled in marketplace coverage.
鈥淭he thing that stands out in Texas, sort of is that really high uninsured rate,鈥� said Dave Radley, senior scientist for the Commonwealth Fund鈥檚 Tracking Health System Performance initiative. 鈥淗aving health insurance sort of is the first step to making sure that people can get access to primary care or any kind of health care.鈥�
Researchers also pointed out the changes to immigration policy could lead to worse health system performance that wouldn鈥檛 be accounted for in the most recent data.
For example, the Trump administration proposed a rule change related to . Experts warned it could create a 鈥渃hilling effect鈥� in migrant communities and worsen uninsured rates among Texas children.
Health officials have also noted fewer community members engaging with preventive services because of fears about immigration crackdowns and recent U.S. Immigration and Customs Enforcement, or ICE, activity.
Dr. Joseph Betancourt, president of the Commonwealth Fund, said providers and researchers expect 鈥渨ith the current environment鈥� that health disparities will worsen, which could have significant implications for communities that are already experiencing vast disparities.
He said some of the 鈥渕ore drastic immigration actions鈥� started in 2025 and are still happening. As a provider himself, Betancourt said there鈥檚 鈥渘o doubt鈥� that there鈥檚 been a chilling effect on people seeking out health care and critical services 鈥� regardless of their legal status.
鈥淚f a virus emerges, it's not asking its victim if it's documented or not,鈥� Betancourt said. 鈥淲e really need to be more thoughtful in a public health approach and a thoughtful approach to immigration enforcement. Our concerns today are real, and I think that鈥檚 what we鈥檙e beginning to see. Our data doesn鈥檛 reflect that quite yet.鈥�
Abigail Ruhman is 四虎影院鈥檚 health reporter. Got a tip? Email Abigail at aruhman@kera.org.
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