Health care access and economic insecurity top a list of challenges for Texas children

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Gaps in access to health care, economic insecurity and mental health challenges exacerbated by the COVID-19 pandemic continue to top the list of challenges currently facing Texas children today, according to a new study released by the nonprofit Every Texan on Thursday.

The 2024 Texas Kids Count Data Book follows-up on a similar survey published in June by the Annie E. Casey Foundation that compares data focused on children from each of the 50 states — plus Washington, D.C. and Puerto Rico. Compared to all U.S. states, the June study ranked Texas 43rd in child well-being indicators — which include economic security, health and education.

Driving many of these factors is the state’s poverty rate, which at 18% continues to exceed the national average, and is among several other areas that Texas trails behind the nation. The child poverty rate has exceeded the national average at least every year since 2010. According to the Every Texan study, about 2.9 million Texas children live in households that are above the poverty line but earn below what would be considered a living wage.

Children’s advocates spoke about the survey’s results during a Thursday discussion in which they proposed solutions to the state’s ongoing health and education challenges. At the event, moderated by The Texas Tribune’s Stephen Simpson, panelists proposed ways that Texas can better ensure that parents are able to enroll their children in health care programs like Medicaid.

As of 2023, about 12% of Texas children lack health insurance, more than double the national average. The uninsured rate among Texas children has exceeded the national rate each year since at least 2013. In Texas, the rates vary by age in the state with those aged 6 to 18 more likely to be uninsured than those younger than 6 years old.

Alec Mendoza, senior policy associate for health at Texans Care for Children, said the state’s Medicaid eligibility criteria is “confusing and overwhelming” for parents, which can lead them to believe they aren’t actually eligible to enroll themselves or their children in the insurance program.

“Families are lacking the information,” Mendoza said. “Even when they are getting that information, they aren’t trying to enroll. Both of these things, these issues, lead to the numbers that we are seeing today.”

The state Legislature also can help ensure parents have better access to Medicaid, he added. Two bills filed this session, one in the House and another in the Senate, would allow parents applying for the Supplemental Nutrition Assistance Program to also enroll their child in Medicaid, if they are eligible.

Families focused on putting food on the table often put health care on the backburner, Mendoza said, until there is an emergency. Legislation allowing for parents to apply for enrollment in SNAP and Medicaid simultaneously would provide some relief.

Every Texan’s study also found that Texas children are facing significant mental health challenges, with variation depending on race and ethnicity. In 2023, more than a quarter of Black and Latino students aged 14 to 18 reported experiencing “debilitating anxiety, depression, or stress” affecting their daily lives. About 35% of white students the same age reported similar feelings.

Broad access to online information and internet technologies might be having an impact, said Jessica Knudsen, CEO and president of the Clarity Child Guidance Center. The proximity to technology throughout the day also makes it more difficult for them to create boundaries with it.

“Kids have a 24/7 fire hose of not just information, but social media [and] access for bullying,” she said. “So it’s very hard for them to disconnect, and so that’s probably why we’re seeing that significant increase in anxiety.”

Spending per capita under the Available School Fund in Texas schools also declined from the 2022-23 to 2023-24 academic year by more than $200, according to Texas Education Agency data, which the Every Texan study says “raises concerns about the state’s capacity to provide high-quality early education among dwindling financial resources.” The fund is one source of revenue for the Foundational School Program, the primary source of state funding for Texas public schools. This rate is influenced by average daily attendance, which has taken a hit in Texas and nationwide since the COVID-19 pandemic.

About one-in-five Texas students were chronically absent during the 2022-23 school year, meaning they missed at least 10% of all school days. According to Jessica Weaver, CEO of Communities In Schools of San Antonio, the best way to help students attend school more is by helping them access basic needs, like food, clothing and shelter. Her organization works directly with students frequently absent from school in the San Antonio area.

Getting a basic education is essential for a student’s economic mobility, Weaver added, but schools require better resources to be a place where students and staff can feel a community of support.

“It’s hard right now, right?” Weaver said. “Teachers and public schools are not valued in our language in the way that they need to be valued. It’s hard for kids to be walking into these spaces where the adults haven’t been valued at the level they need to be valued.”

Disclosure: Clarity Child Guidance Center, Every Texan and Texans Care for Children have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.