The state of Texas continues to grow in size and diversity. Texas is the second most populous state in the nation and gained more new residents from July 2022 to July 2023 than any other state in the country.1 With this increase in population, the priorities and top issues in the state may experience a shift.

Episcopal Health Foundation and SSRS conducted the sixth wave of the Texas Health Tracking Survey with a representative sample of Texas adult residents from October 18 through December 19, 2023 to understand opinions on state
health policy and issues surrounding health care access and affordability.

As in previous years, support for expanding Medicaid to cover more low-income adults under the Affordable Care Act (ACA) is high with 71 percent of Texas adults in support of expansion. Favorability of the program is also high with 70 percent saying they are somewhat or very favorable of the Texas Medicaid program.

While most Texans support the program and its expansion, most are also unsatisfied with how the state is currently handling health care for its most vulnerable residents. Seven in ten say the state is not doing enough to ensure low-income adults can get the health care they need. A majority also say the state is not doing enough for children (57%). About half say the state is not
doing enough for pregnant women (50%) and immigrants (48%).

Nearly half of Texas adults have difficulty affording health care (47%) with\ significant disparities by race and ethnicity as well as household income and age. The high costs of medical care leads many to skip or postpone getting the health care they need. Overall, almost two-thirds of Texas adults have skipped
or postponed some sort of health care because of the cost (64%) in the past 12 months.