Texas Falls Short on Ensuring Health Equity for Every Child

All children deserve the opportunity for a healthy life. However, in Texas, not all children have the food security, healthcare access, and economic security they need to thrive due to disparities rooted in systemic racism, according to Every Texan’s new report Texas KIDS COUNT: Health Equity for Every Texas Child. Public policy can improve health equity for all Texas children, and policymakers have a ripe opportunity this Legislative Session to make practical and critical changes that ensure all Texas children have the opportunity to thrive.

Millions of Texas children without enough food to eat

The KIDS COUNT report found that even prior to the start of the COVID-19 pandemic in March 2020, millions of Texas children struggled to have their basic needs met. Some counties, particularly those in the panhandle and the Rio Grande Valley, saw up to 35% of their child populations experiencing food insecurity in 2018. Of Texas households with children surveyed during the pandemic, one in five — or about 1.6 million Texas children — did not have enough to eat in the past week, and more than one in three Black families and one in four Hispanic families experienced hunger. 

The Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), the two central programs meant to combat child food insecurity, often come up short due to limited eligibility, under-enrollment among those who do qualify, and insufficient support for those enrolled. Only half of the 1.5 million Texas mothers and children eligible for WIC participated in the program in 2017. For those who did participate, the average benefit was just $26 a month. About one-quarter of food insecure children live in households excluded from all federal nutrition programs, and half of families receiving SNAP continue to experience food insecurity. 

An inaccessible education safety net

Many families unable to access food at home rely on public schools to fill in the gaps with the Free and Reduced Price Lunch (FRPL) program. School closures due to the pandemic have further highlighted the importance of schools not only in providing education, but also helping meet children’s basic nutritional needs and providing childcare for working parents. However, amidst school closures, Texas has one of the worst home internet access rates for children nationwide. Over 30% of Texas children did not have access to a computer or internet in 2018. This inequitable access to education over the past year and a half is expected to lead to significant learning delays and increased dropout rates.

The highest children’s uninsured rate in the country — and growing

In addition to inequitable access to food and education, Texas children also suffer from inequitable access to healthcare. Texas has the worst rate of child health insurance in the nation — 12.7% — which is over twice the national rate. Hispanic children in Texas are twice as likely as others to be uninsured. However, it is important to note that these rates were recorded pre-pandemic. The number of children who have lost insurance during the pandemic due to their parent’s loss of employment is estimated to be about 6 million nationally, 10% of whom would not qualify for insurance through the Children’s Health Insurance Program (CHIP) or Medicaid. Many more eligible children will likely not enroll due to lack of information or fears stemming from the public charge rule (now defunct under the Biden Administration), which deterred mixed-immigration-status families from enrolling their U.S. citizen children in benefits they are entitled to receive, due to fear of deportation.

Recommendations for advancing health equity for every Texas child

The ongoing crisis in Texas has only exacerbated a lack of access to the health insurance, food security, and economic opportunity needed for a healthy childhood. Due to systemic racism, children from mixed-immigration-status families and children of color are more likely than white children to face these challenges. The following are a few of the key policy changes recommended by Every Texan to begin the work of recovering from the pandemic in a way that advances health equity and a fair opportunity for all Texas children to thrive. 

  • Reduce barriers that deter Texas families from accessing the food they need to stay healthy. Ensuring that food benefits are adequate and promoting outreach so that all who need them are enrolled will help address the mounting rates of food insecurity seen over the past year.
  • Properly fund education and base funding on enrollment rather than attendance. Schools must be properly funded to help sustain the safety net they provide and address education losses that happened during school closures. One way to do this is to base funding on enrollment rather than attendance, as many children have been unable to attend classes due to a lack of internet (and were unable to attend school regularly due to other external factors even pre-pandemic).
  • Expand Medicaid eligibility and address barriers to enrollment. Texas’ lawmakers refusal to accept Medicaid expansion funding leaves federal dollars on the table and millions of Texans without access to healthcare. Expanding eligibility and funding outreach to ensure those who are eligible have the tools to enroll will ensure that Texas improves from last in the nation in terms of children uninsured rates.

These are only a few of the key findings and recommendations presented in the report. To explore the interactive report’s full summary of findings, identify the biggest challenges facing children in your county, and see all policy recommendations, click here

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Every Texan gratefully acknowledges Methodist Healthcare Ministries of South Texas, Inc., for their financial support of this publication. The opinions expressed in the report are those of Every Texan and do not necessarily reflect the views of Methodist Healthcare Ministries.

This report is part of the Texas KIDS COUNT project. KIDS COUNT is a national and state-by-state effort to track the status of children in the U.S. funded by the Annie E. Casey Foundation. Check out the Kids Count Data Center for extensive child well-being data on kids across the U.S. and for each of Texas’ 254 counties. This research was funded in part by The Annie E. Casey Foundation; Inc., however, findings and conclusions presented in this report are those of the authors alone and do not necessarily reflect the opinions of the Foundation.

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