‍Shao-Chee Sim, Vice President for Research, Innovation and Evaluation, Episcopal Health Foundation‍

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Having a usual source of health care has always been an important aspect of U.S. health care and health policy discussions as regular health care access is associated with better health outcomes. For instance, patients with a usual source of care are more likely to receive recommended preventive services such as flu shots, blood pressure screening, cancer screening, and more. Furthermore, people who are uninsured are more likely to lack a usual place for medical care as compared to those with health insurance.

In Texas—with the highest uninsured rate and the greatest number of uninsured residents in the U.S.—Episcopal Health Foundation (EHF), in partnership with SSRS, has studied this issue for the past four years (2018-2021). Through a statewide poll (2021 report available in March), EHF has documented Texans’ views on state health policy priorities and their experiences with health care accessibility and affordability.

Texans Usual Places of Health Care

In 2021, 41% of Texans reported that a doctor’s office is their usual source of health care, while 18% Texans relied on clinics or health centers as their go-to place for health care last year (Chart 1). However, almost 3 in 10 (29%) Texans reported that they did not have a usual source of care or relied on emergency room care in 2021. Interestingly, data over the past four years shows the sources of usual health care remain remarkably consistent (Chart 2).

Race/Ethnicity, Income, and Insurance Status

Overall, lower-income, Hispanic, and uninsured Texans are more likely to say they have no regular place for medical care or they go to the emergency room. Nearly four in 10 (38%) Hispanic adults report not having a usual source of care (Chart 3).

The data is remarkably similar when comparing the responses between lower-income Texans and higher-income Texans (Chart 4).

Nearly half (48%) of uninsured Texans reported that they did not have usual source of medical care compared to only 25% of insured Texans (Chart 5).

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Implications

As discussed earlier, evidence shows having a usual source of medical care is associated with increased preventive health screening and improved health outcomes. EHF’s statewide polling data across the past four years consistently show that three in 10 adult Texans do not have a usual source of medical care and Hispanic, lower-income, and uninsured Texans fare worse than other Texans. In another statewide COVID-19 poll, EHF documented that, six months after the pandemic started, more than one-third of Texans were still skipping or delaying medical care, and 70% of those who skipped medical care were putting off their medical and dental check-ups or exams. The data further support an earlier EHF-commissioned report that highlights the increased economic costs of health disparities during the COVID-19 pandemic.

As the impact of the health care crisis during COVID-19 continues to unfold, we urge policy makers to consider measures to expand health insurance coverage for uninsured Texans. Equally important, policy makers and other stakeholders should educate Texans, regardless of health insurance status, about the importance of having a regular source of medical care that can hopefully lead to better health outcomes. The data also suggests that it is important to invest in health prevention and health literacy efforts to ensure Texans have the knowledge and knowhow to access and navigate health and healthcare services in the state.

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