Improving the Health of Texans in a Fiscally-Sustainable Way


Positive health outcomes and a high quality health care system are as critical to the lives of Texans as they are to the economic health of communities across the state. The physical and mental health of Texans shapes our productivity, economic vitality and quality of life.

Yet health remains one of our most profound challenges because of our large uninsured population, rising health care costs, and poor health outcomes.

Texans need to engage in a thorough, thoughtful conversation about how to produce the best health outcomes, put limited resources to their most effective use, and deliver health care more efficiently.


  • Texas lacks enough providers to deliver high quality care to all.

    The state ranks 45th among states in the number of primary care doctors per capita and 49th in the number of mental health providers per capita. Provider shortages in Texas, which especially impact rural areas, are projected to worsen in coming years.

  • Health care is increasingly unaffordable.

    In a recent survey, 55% of Texas residents polled said it was difficult for them and their family members to afford health care. More than 60% of Texans said they or a family member have skipped or put off care due to cost.

  • Populations with higher health needs are growing rapidly.

    Between 2010 and 2050, the population of Texans 65 and over is projected to grow by 263%. Older adults use more health care services than younger people and the majority of adults 65 and over have multiple chronic health conditions. 

  • Despite rising spending, poor outcomes and disparities persist.

    Texas ranks 49th in overall health system performance and last in accessibility and affordability. Health outcomes and access are not equal across the state and vary by geography, race, ethnicity, and income.

  • Health care spending is rising at unsustainable levels.

    The average annual growth in health care expenditures in Texas is 6.9%, which is higher than the growth in most states and higher than the national average of 6%. 

  • Many Texans are not living their healthiest lives.

    One out of every three Texas adults is obese, a rate that has tripled since 1990 – and one out of every five youth (18.5%) is obese. Obesity increases the risk for many costly health conditions such as diabetes, stroke, certain cancers, and high blood pressure.

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