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High Rates of Uninsured Texans Could Complicate Zika Preparedness Across the State

Miguel Gutierrez Jr./KUT

The Zika virus will be front and center as public health officials meet in Austin Monday to discuss infectious disease preparedness in the state. Besides funding issues, though, pockets of high uninsured rates in Texas could make monitoring for the mosquito-transmitted virus more complicated.

Texas has the highest number of uninsured residents in the country, and this complicates an issue Texas could be dealing with in the near future: possible local transmission of the Zika virus. Texas Health Commissioner John Hellerstedt admits it’s something to worry about.

“That’s a problem, that’s been a problem before Zika, and it will probably still be a problem after Zika. Yes, access to care does play a role in this,” Hellerstedt said.

"My big worry without that extra funding is that Zika could be popping up in multiple places on the Gulf coast in Texas, and it's being missed."

The Zika virus is already a complicated virus to deal with. In most people, the symptoms are mild. According to the CDC, common symptoms are fever, rash, joint pain and red eyes – pretty common stuff. But if you are pregnant, it’s more serious. Zika has been linked to hundreds of babies born with microcephaly, including one here in Texas. Dr. Peter Hotez, the Dean of the National School of Tropical Medicine at Baylor College of Medicine, said those mild symptoms make learning the scope of the virus pretty difficult.

“Many of these diseases could be very subtle and easily overlooked. People might not recognize a fever and a rash to being associated with Zika or Dengue,” Hotez said. “So it really [calls] for going into area clinics, community clinics, and actively sampling people who could have these diseases to see how widely prevalent they are.”

People are less likely to seek help at a clinic if they don’t have insurance, especially if the symptoms are mild. That’s why Hotez said the state would probably need to spend money doing more active surveillance for the virus –  especially in places like the Rio Grande Valley, which is considered vulnerable to mosquito-borne illnesses and has some of the highest uninsured rates in the state. Hotez said surveillance in places like that isn’t complicated, but they are “labor-extensive.”

“And because you have to bring in a lot of people to help you do it, it becomes an expense,” he said. “That’s why the federal funds are so urgently needed. So my big worry without that extra funding is that Zika could be popping up in multiple places on the Gulf coast in Texas, and it’s being missed.”

However, Commissioner Hellerstedt argues that areas of the state where there are high rates of travel-related Zika cases are probably the most likely to have local transmission of the virus.

“And if you look at that, it really corresponds to the largest population areas, the largest metropolitan areas in the state.”

However, Hotez says that means surrounding counties are also at risk, and that there are other urban pockets like San Antonio and Austin that aren’t in the clear either. So far there have been nearly 100 reported cases of Zika in Texas – including three pregnant women. 

Gov. Greg Abbott posted a statement online over the weekend in which he addresses the Zika situation in Texas. "The risk of infection for most Texans is low," he said. "Our greatest concern is the possible risk for pregnant mothers and the child they are carrying." He introduced an informative site,, which offers more news and updated information on the virus.

The governor's dog Pancake appears in the video, which you can watch below, to help illustrate the preventive measures Abbott wants all Texans to take to minimize the virus' spread.


Ashley Lopez covers politics and health care. Got a tip? Email her at Follow her on Twitter @AshLopezRadio.
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