AUSTIN (Nexstar) — Texas’ uninsured rate rose in 2018, according to new data from the U.S. Census Bureau released Tuesday. It’s the second consecutive year the state has seen an increase in its uninsured rate. 

“We’re not just a little bit worse,” Anne Dunkelberg with the left-leaning Center for Public Policy Priorities said. “We are over twice the national average in terms of uninsured and there’s a big gap between our uninsured rate and the next-worse states.”

In 2016, 16.6 percent of Texans were uninsured. In 2017, the uninsured rate in the Lone Star State was at 17.3 percent. Last year, it rose to 17.7 percent. Texas is one of eight states where the uninsured rate increased. 

The nationwide uninsured rate last year was estimated to be 8.5% of the total population or 27.5 million people. Between 2017 and 2018, the total number of insured people increased by 0.5% or 1.9 million people. According to experts from the U.S. Census Bureau, this marks the first year-to-year increase in the uninsured rate since 2008-09. 

With more than five million Texans without health insurance, several groups are calling on legislators to make policy changes.

“With five million people involved, it’s not a one-size-fits-all solution, but there are things our state can do and things that our feds need to do,” Dunkelberg said.

Texas is one of 14 states that hasn’t expanded Medicaid under the Affordable Care Act. Legislative efforts aimed at Medicaid eligibility expansion and putting the issue up to a vote also didn’t pass during the 86th Legislature. Those opposed to expanding Medicaid have said it’s a broken program that needs reform, rather than an expansion. 

Dunkelberg says one possible reason for the decrease in the state’s uninsured rate could be from a fear factor among immigrant families, “where families are dropping coverage for U.S. citizen children in healthcare and in hunger programs as well.”

“The same chilling effect could also drive down the willingness of our mixed-immigration families to participate in the [2020] Census,” she said.

Lloyd Potter, Texas State Demographer and a professor at the University of Texas at San Antonio, says an accurate 2020 Census count is important because it sets a “statistical foundation for the rest of the decade.”

“If we don’t get that right and if we do have an undercount, that’s going to have implications for the rest of the decade,” he said.

Census data is used for redistricting purposes but also drives what gets appropriated to the state for federal programs.

“If we undercount, we’re likely not to receive all of the appropriates that come back to the state from the federal government,” Potter said.

The Center for Public Policy Priorities is one of a number of groups in Texas participating in outreach efforts to remind people about the importance of the 2020 Census — specifically, as it relates to how it federal funding for programs, like Medicaid, the Children’s Health Insurance Program and the Supplemental Nutrition Assistance Program, commonly known as SNAP.

“There’s a saying that for health, you can pay now or you can pay later and so one of the things to prevent a lot of chronic disease and other things is to eat healthy,” Joy Casnovsky, deputy director of the Sustainable Food Center in Austin, said.

In fiscal year 2018, Texas received $6 billion for SNAP and $22.8 billion for Medicaid.