Texas hospitals reported more than $11 billion in uncompensated health care charges in 2006, and the highest rate of uninsured in the nation, with 25 percent of the population, or 5.5
million people, lacking insurance. An estimated 17 percent of the uninsured are not citizens and are therefore ineligible for most forms of assistance. About 1.4 million of the uninsured are
children and 3.6 million are adult citizens or legal permanent residents. About 60 percent of Texas' uninsured adults have incomes below 200 percent of the federal poverty level, typically
an upper boundary for assistance programs.

According to Uncompensated Care in Texas: Moving Toward Uniform, Reliable and Transparent Data Measuring Residual Unreimbursed Uncompensated Care Costs, a new report from Texas HHS, an "uncoordinated patchwork of state and federal programs that provide some reimbursement for portions of that care" complicate a clear assessment of the problem. In addition, different programs have differing definitions of allowable uncompensated care, and many of those are outside the control of state policymakers. Nevertheless, the report goes on to outline seven recommendations as to how data collection and analysis could be conducted giving a more accurate view of the situation.