Texas ranks as nation's worst state for mental health care

Based on its abysmal rate of insurance coverage, Texas ranks as the worst U.S. state for mental health care in a new analysis by Forbes Advisor.

At 21.5%, the Lone Star State had the highest percentage of adults with any mental illness who are uninsured, according to the study. What's more, it had the highest percentage of adults with a cognitive disability who couldn't see a doctor due to cost (40.65%) and the highest percentage of young people who had a major depressive episode in the past year and didn't get treatment (73.1%).

Further, Texas had the fourth-highest percentage of kids with private health insurance that doesn't cover mental or emotional problems (13.8%). Additionally, its number of health treatment centers per 10,000 businesses was the nation's fifth-lowest at 42.

In common with eight of the list's 10 worst performers, Texas is among the 10 U.S. states that have so far declined to accept the federal Medicaid expansion, which would offer money to cover healthcare for its most impoverished residents. The two states ranking just ahead of Texas on the Forbes list are Mississippi and Alabama, respectively.

"It looks like most of the reasons Texas secured its spot on the list were insurance related or related to health care access, in terms of adults being unable to see a doctor due to costs," said Zoi Galarraga, digital public relations manager for Forbes Advisor, a personal finance-focused sister site to Forbes magazine.

Meanwhile, among the 10 states Forbes identified as having the best mental health care, just one — Wisconsin — had turned down the Medicaid expansion. The top three in respective order are Vermont, Massachusetts and Rhode Island. 

By rejecting the Medicaid expansion, Texas slams the door on more than $5 billion in federal funds annually, according to a 2020 study by Texas A&M's Bush School of Government at Public Service. At the same time, 18% of Texans have no health insurance, the highest rate in the nation, U.S. Census numbers show.

Republicans, who hold all the levers of power in Texas government, have opposed Medicaid expansion since it became available in 2014 under the Affordable Care Act.

Despite pledging to make mental health a priority in the wake of the Uvalde school shooting, Gov. Greg Abbott has repeatedly pledged to reject the additional federal funding, calling it a "massive expansion of an already broken and bloated Medicaid program."

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