Dallas County among nation’s top counties for uninsured


Last week we learned that Texas is near the top of the list when it comes to states where people lack health insurance. When you zoom in to the local level, it turns out that Dallas County has many, many uninsured people, too.

Dallas County ranked ninth in the nation with 26.7 percent of its residents lacking health insurance, according to the U.S. Census Bureau’s 2012 American Community Survey released last week.

In all, six of the nation’s top 10 uninsured counties were in Texas, according to the survey. Texas ranked near the top of the nation’s uninsured list in 2012, along with Nevada, after leading the nation in 2011. A quarter of Texas residents did not have health insurance last year while 25.2 percent of Nevada residents did not have health insurance. Both figures are within the survey’s margin of error, so one state cannot be said to be ahead of the other.

Within the Dallas-Fort Worth area, there were stark differences: Rockwall County fared best with 13.1 percent of residents without health insurance. In the middle were Collin County (14.7 percent of residents uninsured), Denton County (16.7 percent) and Tarrant County (22.5 percent).

A few other findings from the annual survey of 2.4 million households in 2012:
– There are four counties in the country where more than 30 percent of the residents do not have health insurance. Three are in Texas, along the border with Mexico: Hidalgo County led the nation with 36.8 percent of its residents without health insurance. Cameron County had 34.3 percent and Webb County 33.7 percent.
– The six counties in the country with the lowest percentage of uninsured residents were all in Massachusetts, which implemented health care reform in 2006 under then-Governor Mitt Romney, whose plan shares many similarities with Obamacare.
– Of Texas’s four cities with the highest percentage of residents that have health insurance, three are in the D-FW area. About 89 percent of Allen and Frisco residents had health insurance in 2012 and in Flower Mound nearly 93 percent of residents were insured.

In the Dallas metro area, which by the Census Bureau’s definition also includes Arlington, Denton, Irving, Plano and Richardson, the type of health insurance residents have is steadily changing. Among the 25 largest metro areas in the country, Dallas-Fort Worth experienced one of the biggest increases from 2010 to 2012 in the percentage of residents under 65 with public health insurance, primarily Medicaid. Dallas’s proportion of residents on public insurance increased 1.9 percentage points from 15.4 percent to 17.3 percent.

Miami and Denver saw the biggest increases in public insurance adoption followed by Orlando, Philadelphia, Dallas and Tampa. The growth of public insurance in Dallas accounts for all of the loss of private insurance and a slight decrease in uninsured residents.

The American Community Survey began collecting health insurance coverage information in 2008. The release of last week’s data only covers counties and places with 65,000 or more people.

We also wanted to explain why these numbers differ from the Current Population Survey, which Bob Garrett reported on for a Sept. 17 blog post. For the annual American Community Survey, the Census Bureau selected 3.5 million homes in 2012 that they deemed would be a representative sample of the country. From that pool of homes, they received 2.4 million responses by mail, phone interviews and in-person interviews.

On the other hand, the Current Population Survey is a survey of 54,000 households per month in a joint effort by the Census Bureau and Bureau of Labor Statistics. A household is interviewed for four consecutive months and then the same four months the following year to accurately compare year-to-year experiences. Both studies have a margin of error, which in addition to the different methodologies, is why the Current Population Survey says 24.6 percent of Texas residents do not have health insurance and the American Community Survey says 25 percent are uninsured.