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    health conscious

    Texas has the 5th highest healthcare costs in the nation, Forbes says

    Amber Heckler
    Mar 26, 2024 | 11:05 am
    Healthcare, doctor visit, doctor's office, patient

    Texans are the most likely people in the nation to avoid going to the doctor due to cost, the report found.

    forbes.com/

    A new Forbes Advisor study shedding light on Americans' top financial worries has revealed Texas has the 5th highest healthcare costs in the nation.

    Forbes Advisor's annual report compared all 50 states and Washington, D.C. across nine different metrics to determine which states have the most and least expensive healthcare costs in 2024.

    Factors that were analyzed include the average annual deductibles and premiums for employees using single and family coverage through employer-provided health insurances; the percentage of adults who chose not to see a healthcare provider due to costs within the last year; among others. Each state was ranked based on its score out of a total 100 possible points.

    Texas was No. 5 with a score of 91.38 points. North Carolina was No. 1, followed in order by South Dakota, Nebraska, and Florida.

    According to Forbes, out-of-state families considering a move to the Lone Star State should be aware of the state's troubling statistics when it comes to family healthcare. More specifically, nearly 15 percent of Texas children had families who struggled to pay for their medical bills in the past 12 months, the highest percentage in the nation.

    Furthermore, Texans have the highest likelihood in the U.S. to skip seeing a doctor because of cost. The report showed 16 percent of Texas adults chose not to see a doctor in the past 12 months due to the cost of healthcare.

    "Unexpected medical bills and the cost of healthcare services are the top two financial worries for Americans this year, according to a recent KFF health tracking poll," the report said. "These financial fears have real-world consequences. The high cost of healthcare is leading some Americans to make tough choices—often at the expense of their health."

    In the category for the percentage of adults who reported 14 or more "mentally unhealthy" days out of a month, who could not seek healthcare services due to cost, Texas ranked No. 3 in the U.S. with 31.5 percent of adults experiencing these issues.

    The report also highlighted the crystal clear inequality in the distribution of healthcare costs across the U.S.

    "In some states, residents face much steeper healthcare expenses, including higher premiums and deductibles, which make them more likely to delay medical care due to costs," the report said.

    For example, Texas' average annual premiums for both plus-one health insurance coverage ($4,626, according to the study) and family coverage ($7,051.33) through employer-provided policies was the No. 4-highest in the nation.

    Elsewhere in the U.S.

    The state with the most expensive healthcare costs is North Carolina, with a score of 100 points. 27 percent of adults in North Carolina reported struggling with their mental health who could not seek a doctor due to cost, and 11.3 percent of all adults in the state chose not to see a doctor within the last 12 months because of costs.

    Hawaii (No. 50) is the state with the least expensive healthcare costs, according to Forbes. Hawaii had the lowest percentages of adults struggling with mental health (11.6 percent) and adults who chose not to see a doctor within the last year (5.7 percent). The average annual premium for employees in Hawaii using a family coverage plan through employer-provided health insurance is $5,373.67, and the average annual deductible for the same family coverage plan is $3,115.

    The top 10 states with the most expensive healthcare are:

    • No. 1 – North Carolina
    • No. 2 – South Dakota
    • No. 3 – Nebraska
    • No. 4 – Florida
    • No. 5 – Texas
    • No. 6 – South Carolina
    • No. 7 – Arizona
    • No. 8 – Georgia
    • No. 9 – New Hampshrie
    • No. 10 – Louisiana
    The full report and its methodology can be found on forbes.com.
    texasforbesreportshealthcare
    news/city-life

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    income analysis

    This is the family income needed for one parent to stay home in Texas

    Amber Heckler
    Dec 5, 2025 | 10:11 am
    SmartAsset, income analysis, stay-at-home parents
    Photo by Vitaly Gariev on Unsplash
    With costs to raise a child soaring over $20,000 a year in Texas, some households might decide to have one parent work while the other stays at home to raise their child.

    The cost of raising a child has ballooned in major metros like Dallas-Fort Worth, forcing many families to weight the choice between paying for child care or having one parent stay home full-time.

    A recent analysis from SmartAsset determined the minimum income one parent needs to earn to support their partner staying at home to raise one child in all 50 states. In Texas, that amount is just under $75,000.

    The study used the MIT Living Wage Calculator to compare the annual living wages needed for a household with two working adults and one child, and a household with one working adult, a stay-at-home parent, and one child. The study also calculated how much it would cost to raise a child with two working parents based on factors such as "food, housing, childcare, healthcare, transportation, incremental income taxes and other necessities."

    A Texas household with one working parent would need to earn $74,734 a year to support their stay-at-home partner and their child, the report found. If both parents worked in the household, it would require an additional $10,504 in annual income to raise their child.

    SmartAsset said the cost to raise a child in Texas in a two-working-parent household adds up to $23,587. Raising a child in North Texas, however, is slightly more affordable. A separate SmartAsset study from June 2025 determined it costs $22,337 to raise a child in Dallas-Fort Worth.

    In the report's ranking of states with the highest minimum income needed to support a family with one working adult, a stay-at-home parent, and one child, Texas ranked 32nd on the list.

    In other states like Massachusetts where raising a child can cost more than $40,000 a year, the report's author says families will look for ways to reduce any financial burdens.

    "This often includes considerations around who’s going to work in the household, and whether young children will require paid daycare services while parents are occupied," the report said. "With tradeoffs abound, many parents might seek to understand the minimum income needed to keep the family afloat while allowing the other parent to stay home to raise a young child."

    The top 10 states with the lowest minimum income threshold to support a three-person family on one income are:

    • West Virginia – $68,099
    • Arkansas – $68,141
    • Mississippi – $70,242
    • Kentucky – $70,408
    • North Dakota – $70,949
    • Oklahoma – $71,718
    • Ohio – $72,114
    • South Dakota – $72,218
    • Alabama – $72,238
    • Nebraska – $72,966
    texasincomesmartassetfamily
    news/city-life
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