Texas has not expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 does not apply to a state expansion population. This model counts no Texas adults as subject.
The requirement matters for Texas in a different way: if the state expanded Medicaid later, its expansion adults would report from day one. The American Community Survey counts about 3,269,994 uninsured Texas adults with household income at or below 138% of the poverty line, the population an expansion would cover and the requirement would then reach.
Key figures
| Measure | Texas |
|---|---|
| Expansion state | No |
| Subject to the requirement via waiver | No |
| Expansion pool (adults 19 to 64) | 0 |
| Adults subject, strict definition | 0 |
| Adults subject, permissive definition | 0 |
| Share of expansion pool subject | 0.0% |
| Projected coverage loss by 2034 | 0 |
| Hardship exception status | Non expansion |
| Early implementer | No |
| Ex parte capability score (0 to 100) | n/a |
Counties in Texas: uninsured adults below 138% of poverty
Harris County (531,833), Dallas County (291,467), and Tarrant County (237,789) hold the most uninsured low-income adults in Texas.
| County | Uninsured adults at or below 138% FPL | Poverty rate | Working-age population |
|---|---|---|---|
| Harris County | 531,833 | 16.0% | 2,954,626 |
| Dallas County | 291,467 | 14.0% | 1,619,263 |
| Tarrant County | 237,789 | 11.0% | 1,321,051 |
| Bexar County | 227,027 | 15.0% | 1,261,262 |
| Travis County | 161,714 | 11.0% | 898,410 |
| Collin County | 130,497 | 6.0% | 724,982 |
| Denton County | 112,491 | 7.0% | 624,950 |
| Fort Bend County | 95,762 | 7.0% | 532,014 |
| El Paso County | 93,029 | 20.0% | 516,830 |
| Hidalgo County | 89,322 | 28.0% | 496,232 |
| Williamson County | 74,930 | 6.0% | 416,275 |
| Montgomery County | 72,913 | 9.0% | 405,072 |
| Brazoria County | 42,514 | 8.0% | 236,191 |
| Cameron County | 42,506 | 25.0% | 236,142 |
| Bell County | 41,246 | 15.0% | 229,144 |
| Galveston County | 38,405 | 11.0% | 213,360 |
| Nueces County | 37,381 | 17.0% | 207,672 |
| Lubbock County | 35,033 | 17.0% | 194,630 |
| Hays County | 30,641 | 13.0% | 170,230 |
| Brazos County | 28,613 | 24.0% | 158,960 |
| McLennan County | 28,067 | 18.0% | 155,926 |
| Webb County | 27,486 | 21.0% | 152,699 |
| Jefferson County | 26,871 | 18.0% | 149,286 |
| Smith County | 24,772 | 13.0% | 137,620 |
| Ellis County | 22,744 | 8.0% | 126,355 |
| Johnson County | 20,787 | 11.0% | 115,482 |
| Guadalupe County | 19,774 | 9.0% | 109,858 |
| Comal County | 19,233 | 6.0% | 106,848 |
| Midland County | 18,533 | 11.0% | 102,961 |
| Kaufman County | 18,438 | 10.0% | 102,432 |
| Parker County | 17,308 | 8.0% | 96,154 |
| Ector County | 17,296 | 16.0% | 96,091 |
| Randall County | 15,453 | 9.0% | 85,852 |
| Taylor County | 15,411 | 15.0% | 85,615 |
| Grayson County | 14,607 | 11.0% | 81,152 |
| Wichita County | 13,998 | 16.0% | 77,765 |
| Rockwall County | 13,289 | 4.0% | 73,827 |
| Gregg County | 12,826 | 17.0% | 71,254 |
| Tom Green County | 12,422 | 12.0% | 69,014 |
| Potter County | 12,045 | 21.0% | 66,915 |
| Hunt County | 11,466 | 12.0% | 63,701 |
| Bastrop County | 10,998 | 12.0% | 61,101 |
| Liberty County | 10,652 | 18.0% | 59,178 |
| Walker County | 9,911 | 19.0% | 55,060 |
| Coryell County | 9,862 | 11.0% | 54,790 |
| Bowie County | 9,532 | 17.0% | 52,954 |
| Victoria County | 9,305 | 17.0% | 51,694 |
| Angelina County | 8,878 | 16.0% | 49,322 |
| Orange County | 8,827 | 12.0% | 49,038 |
| Henderson County | 8,393 | 15.0% | 46,626 |
| Wise County | 7,939 | 9.0% | 44,105 |
| San Patricio County | 7,271 | 16.0% | 40,396 |
| Harrison County | 7,156 | 16.0% | 39,756 |
| Waller County | 6,870 | 13.0% | 38,166 |
| Nacogdoches County | 6,812 | 22.0% | 37,847 |
| Anderson County | 6,787 | 16.0% | 37,706 |
| Starr County | 6,485 | 33.0% | 36,026 |
| Hood County | 6,287 | 9.0% | 34,930 |
| Van Zandt County | 6,279 | 13.0% | 34,883 |
| Hardin County | 5,847 | 13.0% | 32,486 |
| Maverick County | 5,811 | 23.0% | 32,286 |
| Polk County | 5,685 | 16.0% | 31,586 |
| Medina County | 5,651 | 10.0% | 31,396 |
| Rusk County | 5,599 | 13.0% | 31,105 |
| Wilson County | 5,533 | 10.0% | 30,738 |
| Chambers County | 5,436 | 14.0% | 30,200 |
| Navarro County | 5,412 | 16.0% | 30,066 |
| Caldwell County | 5,265 | 14.0% | 29,252 |
| Atascosa County | 5,221 | 14.0% | 29,006 |
| Burnet County | 5,205 | 8.0% | 28,918 |
| Cherokee County | 5,181 | 17.0% | 28,784 |
| Lamar County | 5,052 | 16.0% | 28,066 |
| Kerr County | 4,960 | 13.0% | 27,557 |
| Kendall County | 4,918 | 5.0% | 27,322 |
| Val Verde County | 4,880 | 16.0% | 27,112 |
| Erath County | 4,774 | 17.0% | 26,522 |
| Wood County | 4,454 | 13.0% | 24,743 |
| Cooke County | 4,372 | 13.0% | 24,291 |
| Upshur County | 4,329 | 15.0% | 24,050 |
| Wharton County | 4,167 | 15.0% | 23,150 |
| Fannin County | 4,012 | 13.0% | 22,292 |
| Brown County | 3,946 | 13.0% | 21,925 |
| Jim Wells County | 3,858 | 23.0% | 21,435 |
| Hopkins County | 3,801 | 13.0% | 21,118 |
| Hill County | 3,726 | 13.0% | 20,702 |
| Bee County | 3,681 | 20.0% | 20,448 |
| Howard County | 3,645 | 15.0% | 20,251 |
| Matagorda County | 3,621 | 22.0% | 20,118 |
| Washington County | 3,534 | 12.0% | 19,636 |
| Hale County | 3,357 | 19.0% | 18,648 |
| Kleberg County | 3,303 | 31.0% | 18,349 |
| Grimes County | 3,265 | 14.0% | 18,137 |
| Jasper County | 3,233 | 23.0% | 17,960 |
| Titus County | 3,128 | 18.0% | 17,376 |
| Austin County | 3,053 | 12.0% | 16,960 |
| Palo Pinto County | 2,898 | 16.0% | 16,101 |
| San Jacinto County | 2,875 | 17.0% | 15,972 |
| Cass County | 2,776 | 18.0% | 15,423 |
| Milam County | 2,515 | 14.0% | 13,971 |
| Uvalde County | 2,474 | 24.0% | 13,742 |
| Aransas County | 2,458 | 18.0% | 13,658 |
| Gillespie County | 2,447 | 9.0% | 13,596 |
| Jones County | 2,411 | 14.0% | 13,396 |
| Shelby County | 2,359 | 23.0% | 13,105 |
| Fayette County | 2,353 | 10.0% | 13,072 |
| Lampasas County | 2,297 | 9.0% | 12,760 |
| Panola County | 2,264 | 14.0% | 12,576 |
| Houston County | 2,232 | 18.0% | 12,402 |
| Limestone County | 2,230 | 21.0% | 12,391 |
| Willacy County | 2,176 | 27.0% | 12,090 |
| Hockley County | 2,173 | 15.0% | 12,073 |
| Moore County | 2,171 | 13.0% | 12,061 |
| Gray County | 2,160 | 17.0% | 12,002 |
| Gaines County | 2,117 | 13.0% | 11,760 |
| Bandera County | 2,095 | 14.0% | 11,637 |
| Tyler County | 2,094 | 18.0% | 11,636 |
| Calhoun County | 2,065 | 9.0% | 11,470 |
| Montague County | 2,064 | 13.0% | 11,466 |
| Frio County | 2,042 | 21.0% | 11,346 |
| DeWitt County | 2,031 | 17.0% | 11,282 |
| Freestone County | 2,030 | 13.0% | 11,280 |
| Hutchinson County | 2,017 | 10.0% | 11,208 |
| Colorado County | 1,981 | 7.0% | 11,006 |
| Andrews County | 1,966 | 12.0% | 10,920 |
| Gonzales County | 1,964 | 13.0% | 10,912 |
| Lavaca County | 1,903 | 10.0% | 10,574 |
| Llano County | 1,894 | 11.0% | 10,520 |
| Burleson County | 1,863 | 12.0% | 10,351 |
| Lee County | 1,849 | 13.0% | 10,274 |
| Falls County | 1,816 | 16.0% | 10,088 |
| Deaf Smith County | 1,792 | 16.0% | 9,958 |
| Eastland County | 1,787 | 16.0% | 9,928 |
| Bosque County | 1,773 | 12.0% | 9,849 |
| Young County | 1,768 | 16.0% | 9,822 |
| Karnes County | 1,735 | 21.0% | 9,642 |
| Scurry County | 1,726 | 12.0% | 9,588 |
| Robertson County | 1,675 | 14.0% | 9,305 |
| Pecos County | 1,652 | 23.0% | 9,180 |
| Leon County | 1,513 | 14.0% | 8,406 |
| Madison County | 1,500 | 12.0% | 8,334 |
| Jackson County | 1,493 | 12.0% | 8,296 |
| Callahan County | 1,413 | 9.0% | 7,850 |
| Nolan County | 1,388 | 16.0% | 7,710 |
| Reeves County | 1,370 | 21.0% | 7,608 |
| Trinity County | 1,328 | 14.0% | 7,378 |
| Dawson County | 1,319 | 25.0% | 7,326 |
| Zapata County | 1,317 | 37.0% | 7,316 |
| Comanche County | 1,307 | 14.0% | 7,258 |
| Wilbarger County | 1,296 | 18.0% | 7,198 |
| Rains County | 1,267 | 11.0% | 7,040 |
| Lamb County | 1,254 | 17.0% | 6,966 |
| Blanco County | 1,238 | 10.0% | 6,876 |
| Live Oak County | 1,236 | 21.0% | 6,868 |
| Camp County | 1,224 | 22.0% | 6,800 |
| Newton County | 1,221 | 24.0% | 6,784 |
| Morris County | 1,175 | 16.0% | 6,529 |
| Terry County | 1,149 | 22.0% | 6,386 |
| Ward County | 1,132 | 14.0% | 6,292 |
| Red River County | 1,107 | 20.0% | 6,150 |
| Clay County | 1,063 | 9.0% | 5,905 |
| Mitchell County | 1,034 | 14.0% | 5,746 |
| Franklin County | 1,032 | 9.0% | 5,732 |
| Somervell County | 1,006 | 7.0% | 5,588 |
| Ochiltree County | 1,006 | 12.0% | 5,588 |
| Duval County | 979 | 22.0% | 5,438 |
| Stephens County | 974 | 17.0% | 5,411 |
| Parmer County | 966 | 10.0% | 5,368 |
| Marion County | 961 | 16.0% | 5,338 |
| Runnels County | 959 | 12.0% | 5,326 |
| Brewster County | 953 | 16.0% | 5,296 |
| Jack County | 951 | 14.0% | 5,284 |
| Sabine County | 923 | 17.0% | 5,126 |
| Zavala County | 897 | 31.0% | 4,984 |
| Archer County | 878 | 12.0% | 4,875 |
| Dimmit County | 825 | 44.0% | 4,581 |
| Winkler County | 767 | 13.0% | 4,260 |
| Hamilton County | 765 | 17.0% | 4,250 |
| Childress County | 752 | 15.0% | 4,180 |
| San Augustine County | 740 | 27.0% | 4,113 |
| Swisher County | 732 | 30.0% | 4,067 |
| La Salle County | 731 | 28.0% | 4,064 |
| Coleman County | 728 | 17.0% | 4,046 |
| McCulloch County | 726 | 13.0% | 4,034 |
| Brooks County | 717 | 33.0% | 3,982 |
| Yoakum County | 715 | 14.0% | 3,972 |
| Dallam County | 714 | 9.0% | 3,964 |
| Goliad County | 706 | 10.0% | 3,922 |
| Refugio County | 664 | 16.0% | 3,690 |
| Castro County | 662 | 12.0% | 3,680 |
| Bailey County | 652 | 13.0% | 3,622 |
| Garza County | 629 | 15.0% | 3,492 |
| San Saba County | 582 | 14.0% | 3,232 |
| Hartley County | 580 | 7.0% | 3,220 |
| Presidio County | 577 | 40.0% | 3,206 |
| Lynn County | 571 | 19.0% | 3,174 |
| Carson County | 566 | 8.0% | 3,142 |
| Haskell County | 547 | 15.0% | 3,038 |
| Martin County | 542 | 17.0% | 3,010 |
| Delta County | 539 | 14.0% | 2,994 |
| Hansford County | 509 | 8.0% | 2,830 |
| Floyd County | 503 | 19.0% | 2,797 |
| Crosby County | 495 | 24.0% | 2,750 |
| Jim Hogg County | 477 | 29.0% | 2,650 |
| Wheeler County | 468 | 18.0% | 2,601 |
| Crane County | 447 | 4.0% | 2,482 |
| Mills County | 423 | 7.0% | 2,348 |
| Hudspeth County | 411 | 25.0% | 2,282 |
| Kimble County | 404 | 12.0% | 2,246 |
| Concho County | 397 | 16.0% | 2,207 |
| Kinney County | 371 | 16.0% | 2,060 |
| Fisher County | 366 | 12.0% | 2,033 |
| Hardeman County | 340 | 11.0% | 1,890 |
| Sutton County | 330 | 17.0% | 1,835 |
| Shackelford County | 328 | 11.0% | 1,822 |
| Knox County | 326 | 11.0% | 1,808 |
| Upton County | 322 | 20.0% | 1,792 |
| Mason County | 321 | 5.0% | 1,784 |
| Hemphill County | 321 | 6.0% | 1,781 |
| Reagan County | 317 | 7.0% | 1,762 |
| Baylor County | 316 | 12.0% | 1,754 |
| Coke County | 308 | 17.0% | 1,714 |
| Donley County | 307 | 11.0% | 1,708 |
| Crockett County | 277 | 9.0% | 1,539 |
| Hall County | 273 | 19.0% | 1,516 |
| Lipscomb County | 262 | 14.0% | 1,454 |
| Cochran County | 258 | 26.0% | 1,434 |
| Sherman County | 256 | 8.0% | 1,420 |
| Schleicher County | 229 | 14.0% | 1,270 |
| Collingsworth County | 217 | 22.0% | 1,204 |
| Oldham County | 198 | 17.0% | 1,098 |
| Real County | 185 | 25.0% | 1,029 |
| Armstrong County | 180 | 6.0% | 1,000 |
| Culberson County | 166 | 22.0% | 924 |
| Jeff Davis County | 161 | 25.0% | 897 |
| Dickens County | 158 | 12.0% | 880 |
| Menard County | 158 | 22.0% | 878 |
| Throckmorton County | 150 | 14.0% | 836 |
| Cottle County | 137 | 24.0% | 760 |
| Irion County | 137 | 7.0% | 762 |
| Briscoe County | 127 | 24.0% | 706 |
| Sterling County | 125 | 2.0% | 694 |
| Motley County | 121 | 9.0% | 673 |
| Edwards County | 119 | 23.0% | 664 |
| Glasscock County | 118 | 5.0% | 657 |
| Stonewall County | 102 | 7.0% | 567 |
| Foard County | 90 | 22.0% | 502 |
| Roberts County | 79 | 15.0% | 440 |
| Terrell County | 67 | 6.0% | 372 |
| Kent County | 66 | 8.0% | 364 |
| Borden County | 61 | 2.0% | 338 |
| McMullen County | 52 | 15.0% | 288 |
| King County | 21 | 28.0% | 115 |
| Kenedy County | 12 | 3.0% | 67 |
| Loving County | 1 | 5.0% | 6 |
State brief and methodology
Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.