The U.S.-Mexico Border Region Faced a Range of Health Challenges Long Before the Current Immigration Surge

Texas’ Lagging Health Infrastructure and Lack of Medicaid Expansion Stand Out

With intense immigration activity at the U.S.-Mexico border this year and attention focused on the plight of newly arriving migrants, a new KFF analysis finds communities along the border faced an array of socioeconomic challenges and weak health infrastructures well before this year’s surge.

Texas – which has the most counties along the border and is the only border state that has not expanded Medicaid under the Affordable Care Act – stands out as facing the greatest challenges with twice the uninsured rate among both its border county (26%) and non-border county (20%) nonelderly residents compared with California, Arizona, and New Mexico.

A major factor behind Texas’ higher uninsured rates is that 1 in 3 nonelderly adults in border counties lack health insurance. Medicaid expansion for adults could reduce the uninsured rate among the state’s nonelderly adults. However, compared with non-border counties, the border counties in the state have higher shares of noncitizens who may be ineligible for Medicaid.

Texas trails the three other border states in its supply of providers in all counties. California and Texas border counties lag other counties in the states in their supply of four types of health care providers: primary care, obstetrics and gynecology, dental, and emergency medicine.

Texas trails the three other border states in its supply of providers in all counties. California and Texas border counties lag other counties in the states in their supply of four types of health care providers: primary care, obstetrics and gynecology, dental, and emergency medicine.

Texas also stands in contrast to the three other border states in the clear differences between its border and non-border country residents in other socioeconomic indicators, pointing to more systemic issues. Texas border county residents have lower education levels, household incomes, and full-time employment rates than the state’s non-border county residents.

Arizona, California, New Mexico, and Texas have 44 counties along the border with Mexico that are home to 8 million people. People in the four border states generally are more likely to be Hispanic, noncitizen immigrants, poor, and uninsured than those in other parts of the country. Across all four states, the large majority (over 80%) of residents in both border and non-border counties are U.S. citizens, with most being U.S.-born citizens. Health and Health Care in the U.S.-Mexico Border Region reveals further distinctions between and within the four border states. Better understanding the characteristics and needs of residents in these areas may help inform efforts to respond to the recent immigration surge.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.