Public Release: 

New report shows more Texas workers getting health insurance from employers

Rice University

HOUSTON - (Oct. 6, 2015) - A larger percentage of Texas workers are getting health insurance through their employers now than before the implementation of the Affordable Care Act (ACA), according to a new report released today by Rice University's Baker Institute for Public Policy and the Episcopal Health Foundation.

The report found 68 percent of workers in Texas now get health insurance through employee-sponsored insurance. That's up from the 67 percent of workers who obtained insurance through their employers in 2013.

"From the outset of the ACA, there were concerns that the law would cause employers to drop health insurance coverage," said Elena Marks, president and CEO of the Episcopal Health Foundation and a nonresident health policy fellow at the Baker Institute. "That didn't happen in Texas. Instead, a larger percentage of workers -- especially low-income workers -- are getting coverage through their employers."

Low-income workers in Texas experienced the largest gains in the percentage covered by employer-sponsored health insurance -- up 12 percent from 2013, when 35.9 percent of low-income workers were covered, to 2015, when 40.3 percent were covered. In addition, the report found more low-income workers in Texas purchased individual health insurance plans since Marketplace enrollment began through the ACA.

"Many large employers may be increasing their offers of health insurance to employees to avoid paying a penalty for not providing affordable coverage," said Vivian Ho, the chair in health economics at the Baker Institute and director of the institute's Center for Health and Biosciences, a professor of economics at Rice and a professor of medicine at Baylor College of Medicine. "Lower-income workers may also be purchasing employee-sponsored health insurance they had previously refused. That way, they avoid paying a penalty for not obtaining coverage."

The report found 85 percent of higher-income Texans get health insurance from their employers. The percentage remained unchanged from 2013 to 2015.

Despite the increases in employee-sponsored health insurance for low-income workers, the group's uninsured rate of 24 percent is still higher than the state average.

Researchers found cost remains the primary reason these workers say they remain uninsured. More than half (55 percent) of uninsured, low-income workers said they can't afford health insurance.

The report is the 15th in a series on the implementation of the Affordable Care Act in Texas co-authored by Marks and Ho.

The Health Reform Monitoring Survey (HRMS) is a quarterly survey of adults ages 18-64 that began in 2013. Today's report is a summary of data extracted from the HRMS surveys in Texas administered between September 2013 and March 2015, with responses from 1,544 Texans.

The HRMS is designed to provide timely information on implementation issues under the ACA and to document changes in health-insurance coverage and related health outcomes. The Baker Institute and the Episcopal Health Foundation are partnering to fund and report on key factors about Texans obtained from an expanded, representative sample of Texas residents (HRMS-Texas).

The HRMS was developed by the Urban Institute, conducted by GfK and jointly funded by the Robert Wood Johnson Foundation, the Ford Foundation and the Urban Institute. The analyses and conclusions based on HRMS-Texas are those of the authors and do not represent the view of the Urban Institute, the Robert Wood Johnson Foundation or the Ford Foundation.


To schedule an interview with Ho, contact Jeff Falk, associate director of national media relations at Rice, at or 713-348-6775. Rice University has a VideoLink ReadyCam TV interview studio. ReadyCam is capable of transmitting broadcast-quality standard-definition and high-definition video directly to all news media organizations around the world 24/7.

To schedule an interview with Marks, contact Brian Sasser, director of communications at the Episcopal Health Foundation, at or 832-795-9404.

Related materials:

Full survey report:

The Episcopal Health Foundation:

Ho bio:

Marks bio:

Photo credit: University

Founded in 1993, Rice University's Baker Institute ranks among the top 10 university-affiliated think tanks in the world. As a premier nonpartisan think tank, the institute conducts research on domestic and foreign policy issues with the goal of bridging the gap between the theory and practice of public policy. The institute's strong track record of achievement reflects the work of its endowed fellows, Rice University faculty scholars and staff, coupled with its outreach to the Rice student body through fellow-taught classes -- including a public policy course -- and student leadership and internship programs. Learn more about the institute at or on the institute's blog,

The Episcopal Health Foundation was established in 2013 and is based in Houston. With more than $1.2 billion in estimated assets, the foundation is a 501(c)(3) not-for-profit corporation that operates as a supporting organization of the Episcopal Diocese of Texas. EHF works to improve the health and well-being of the 10 million people in the 57 counties of the diocese by investing in communities through grant-making, outreach to diocesan churches and critical research to advance community health.

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