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

A new Forbes Advisor study shedding light on Americans' top financial worries has revealed Texas has the fifth highest health care 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 health care costs in 2024.

Factors include the average annual deductibles and premiums for employees using single and family coverage through employer-provided health insurances and the percentage of adults who chose not to see a health care 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 health care. 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 health care.

"Unexpected medical bills and the cost of health care 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 health care 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 health care costs across the U.S.

"In some states, residents face much steeper health care 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 health care 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 health care 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 health care 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 Hampshire
  • No. 10 – Louisiana

The full report and its methodology can be found on forbes.com.

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This article originally ran on CultureMap.

Nurses deserve all the love. Photo by Patty Brito on Unsplash

Texas earns healthy rating as 2nd best state for nurses, Forbes says

health care heroes

With a global pandemic in the rearview and an aging workforce reaching retirement in larger proportions, strong healthcare is becoming increasingly crucial in the United States.

Nurses are in great demand throughout the nation and can make significant impacts in a state like Texas, which was just named the No. 2 best state for nurses in a study by Forbes Advisor.

Texas currently employs more than 231,000 nurses, the second-highest number in the country behind California's 325,620 nurses. Florida rounds out the top three with more than 197,000 nurses employed.

There are several factors to keep in mind when considering a career as a nurse, but one has been in a lot of recent discourse: the salary. The Bureau of Labor Statistics (BLS) says nurses in the U.S. earn a median salary of $81,220 per year. While healthcare company Trusted Health places a Texas nurse's annual salary at $74,540 - lower than places like Florida and California, adjusted cost of living can make Texas more attractive.

"Salary is a significant factor in any professional’s career decisions, but it’s not the only one to weigh when deciding where to work," the report's author wrote. "You should also consider job availability, economic demand, and licensing processes before settling on a place to grow your career."

Regarding job availability, Projections Central estimates there will be a demand for more than 16,000 nursing positions in Texas between 2020 and 2030 - the second-best job outlook in the U.S.

Texas is also part of the Nurse Licensure Compact (NLC), which can help nurses transfer their licenses from other states.

"NLC members grant RNs multi-state licenses, which allow them to practice in any NLC-participating state without jumping through the hoops of meeting a new state’s specific licensing guidelines," the report says. "NLC nurses can offer their skills to another compact state in the event of a crisis and provide telehealth services across compact states."

The full report can be found on forbes.com.

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This article originally ran on CultureMap.

Houston's not so hot for remote workers, as it turns out. thumbor.forbes.com

Houston caught slacking in Forbes study on best cities for remote workers

WFH woes

With many companies encouraging — or commanding — that remote workers return to the office in 2023, more and more Americans are seeking employment opportunities that will give them the freedom to work from elsewhere.

Houston is (remotely) clocking in as the No. 49 best city for remote workers in 2023, according to a study by Forbes Advisor. The study examined 100 U.S. cities and metro areas, and ranked them based on the earning potential of remote workers, internet access, lifestyle amenities, worker friendliness, living costs, and more.

The Bayou City did get some points for providing a quality lifestyle, the report found. Of the cities with the best access to arts, entertainment, and dining establishments, Houston came in No. 8 — outpaced slightly by No. 4 Dallas-Fort Worth.

"Remote work saves workers time and money on commuting and office clothing, while keeping their morale and productivity levels high," the report said. "Ideally, you’d live in a place with an affordable cost of living, high earning potential, reliable internet connection, low taxes, a low unemployment rate, and various entertainment options."

Out of All of Texas, only one region makes the top 10. San Antonio-New Braunfels, Texas, snagged the No. 6 spot. Here's yhe top 10 U.S. metro areas for remote workers are:

  • No. 1 – Miami-Fort Lauderdale-West Palm Beach, Florida
  • No. 2 – Indianapolis-Carmel-Anderson, Indiana
  • No. 3 – Omaha-Council Bluffs, Nebraska-Iowa
  • No. 4 – Tulsa, Oklahoma
  • No. 5 – Detroit-Warren-Dearborn, Michigan
  • No. 6 – San Antonio-New Braunfels, Texas
  • No. 7 – Jacksonville, Florida
  • No. 8 – Tampa-St. Petersburg-Clearwater, Florida
  • No. 9 – Tuscon, Arizona
  • No. 10 – Cleveland-Elyria, Ohio

Houston ranks in dead last when compared to the other Texas cities in the top 50. Behind San Antonio is Dallas-Fort Worth-Arlington, ranked No. 15 nationally. Austin-Round Rock ranks as the third overall best metro area in Texas for remote workers at No. 39.

Austin did great in one category — internet access — but it seems that earning potential and lifestyle amenities just couldn't keep up. for Austinites, it's all in the Wi-Fi: a remote worker's most important tool.

Austin's average internet download speed is 425.90 Megabits per second (Mbps), and when coupled with the wide variety of free Wi-Fi hotspots around the city, Austin earned No. 3 in the category for "cities with the best internet access." And we do like to take advantage of that at restaurants and bars around town.

Rounding out the ranking was El Paso at No. 46, sneaking ahead of Houston, and McAllen-Edinburg-Mission gets an honorable mention at No. 85.

The full study can be found on forbes.com.

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This article originally ran on CultureMap.

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10+ can't-miss Houston business and innovation events for October

where to be

Editor's note: Healthcare and energy conferences headline this month's slate of innovation events in Houston. But there's also time for family-friendly gatherings and pickleball socials. Here’s what not to miss in October and how to register. Please note: this article may be updated to add more events.

Oct. 2 — Joy in Medicine Initiative Symposium

The Houston Methodist Joy in Medicine Initiative Symposium will explore the power of connection in enhancing professional fulfillment for clinicians and healthcare teams, this year with the theme of "Forging New Paths: Leadership, Connection & Innovation to Sustain Joy in Medicine." Hear from Dr. Shlomit Schall, Houston Methodist Physician Organization president and CEO and chief physician executive; Houston Methodist CEO Marc Boom; and Dr. Albert Wu, from Johns Hopkins, author of Therefore, Let us Rejoice: Sustaining Joy in Medicine. Stick around for a networking happy hour.

This event is Friday, Oct. 2, from 8:30 a.m.-4:30 p.m. at Thompson Houston on Allen Parkway. Find more information here.

Oct. 6-7 — Hydrogen Americas Summit and Exhibition

Hydrogen Americas delivers an unparalleled opportunity to explore how hydrogen integrates with CCUS and other energy solutions under the new U.S. and Americas energy paradigm. This event moves to Houston in 2026, providing unmatched access to industry leaders and opportunities. The summit will include CCUS-dedicated sessions integrated directly into the conference programming, providing deeper insights into carbon capture, utilization and storage. Look forward to networking opportunities to connect with global suppliers, regional developers and key policymakers.

This event begins Oct. 6 at George R. Brown Convention Center. Register here.

Oct. 6-7 — Annual Energy Summit — Energy, Risk, and Geopolitics

The 10th annual energy summit is co-hosted by Baker Botts and the Center for Energy Studies at Rice University's Baker Institute. This year's summit, “Energy, Risk, and Geopolitics,” will explore how a changing geopolitical landscape and shifts in supply chain risks are impacting investment, innovation and market dynamics. The two-day program will include discussions spanning petroleum and LNG markets, critical minerals, electricity reliability, AI and power demand.

This event begins Oct. 6 at 7:30 am at James A Baker III Hall. The event will also be livestreamed. Register here.

Oct. 7 – Rockets Get You to Orbit. Culture Gets You to Stay

The Ion will host a morning discussion exploring humanity’s future in space. The event will feature Rick Tumlinson, author of Why Space? The Purpose of People; Scott Solomon, author of Becoming Martian; and David Alexander and Alexander Regier of Rice University’s new Space Humanities Initiative. The conversations will be moderated by EarthLight Foundation Director Junaid Mian.

This event is Wednesday, Oct. 7, from 8:30-11 a.m. at the Ion. Register here.

Oct. 8 — Greentown Labs’ Fall Pickleball Social

Greentown Labs hosts its fall social at Pickle Lab HTX this month. Enjoy friendly matches, networking and light bites. All skill sets are welcome.

This event is Thursday, Oct. 8, from 5:30-7:30 p.m. at Pickle Lab HTX. Register here.

Oct. 10 – Ion Family Tech Festival

Bring the whole family out to the second Ion Family Tech Festival. Kids will get to participate in hands-on STEAM workshops and learn more about STEAM-related careers.

This event is Saturday, Oct. 10, from 9 a.m.-12 p.m. at the Ion. Register here.

Oct. 13 – Mercury Fund Day at the Ion

Don’t miss the latest installment of Mercury Fund Day at the Ion, previously known as Software Day. The recurring monthly event features office hours (by application), a keynote and networking opportunities.

This event is Tuesday, Oct. 13, from 3:30-7 p.m. at the Ion. Register here.

Oct. 14 — Future of Global Energy Conference

This October, the sixth annual Future of Global Energy Conference kicks off, convening influential leaders from across energy, technology, finance and public policy who will come together to explore the forces defining the next era of global energy and Houston’s role in shaping it. Ryan Lance, Executive Chairman of ConocoPhillips and 2027 Chair of the Greater Houston Partnership’s Board of Directors, is the keynote speaker for this year’s conference, bringing a global perspective on rising demand, market volatility and Houston’s role in the next era of energy growth.

This event takes place Oct. 14 at the Marriott Marquis. Register here.

Oct. 17 — Energy Day 2026

Energy Day Houston is the nation’s largest free, family-friendly STEM festival. It features over 50 interactive exhibits and live demonstrations focused on traditional and emerging energy career paths to power up your curiosity.

This event begins at 11 a.m. on Oct. 17 at Sam Houston Park. Get details here.

Oct. 22 — Rice360 Innovation for Healthcare Access Conference

Researchers and innovators from Rice University, the Texas Medical Center, non-profit organizations, healthcare providers and others will come together to explore gaps in healthcare at the Innovation for Healthcare Access Conference. The event will feature speakers, workshops and case study presentations and will focus on innovations for the health of women and children in underserved rural and urban communities across Texas.

This event is Thursday, Oct. 22, from 8 a.m.-5 p.m. at the Rice University BioScience Research Collaborative (BRC). Register here.

Oct. 28-29 – TiECon 2026

TiE Houston, TiE Dallas and TiE Austin are joining forces to host TiEcon Texas 2026 at the Ion this month. The event will focus on how automation, artificial intelligence and emerging technologies are reshaping Texas industries, the economy and daily life. The conference will feature keynotes, panels, fireside chats and the TiE Hatch Pitch Competition.

This event starts Thursday, Oct. 29, at the Ion. Register here.

UH secures $5M in philanthropic gifts to bolster engineering, nursing

major gifts

The University of Houston has received two significant philanthropic gifts to advance innovation and healthcare, the college announced this month.

Manmohan Singh Kalsi and Marie-Luise Schubert Kalsi granted $4 million to UH’s Cullen College of Engineering to support endowed and current funds for graduate fellowships and industry interest in the mechanical and aerospace fields.

The gift is the Department of Mechanical and Aerospace Engineering’s largest donation in years, according to UH, and will establish two endowed professorships to attract and retain leading faculty. It will also create the Kalsi Faculty Research Fund, which aims to take emerging research to the next level.

Additionally, UH says it will also bring industry experts to campus to present and collaborate with students via the forthcoming Kalsi Seminar Series.

Manmohan Kalsi earned both his master’s degree and Ph.D. in mechanical engineering from UH. He went on to found Sugar Land-based Kalsi Engineering in 1978, which pioneered hydrodynamic rotary sealing technology and valve technology for nuclear power plants. In 2014, he established an endowed professorship within Cullen College in honor of the late UH professor Gabriel Fazekas.

"This gift provides a tremendous boost to our department's strategic momentum,” Karolos Grigoriadis, chair of the Department of Mechanical and Aerospace Engineering, said in a news release. “By simultaneously supporting faculty, graduate researchers and collaborative seminars, the Kalsis are strengthening every part of our research enterprise and creating new opportunities for discovery, collaboration and student mentorship.”

Meanwhile, Houston’s The Hamill Foundation also gave a $1 million gift to UH’s Andy and Barbara Gessner College of Nursing. The funds will establish The Hamill Foundation Endowed Professorship in Community Care Nursing, to support a faculty member focused on community-based nursing education, partnerships, research, and outreach to underserved communities in Houston.

Additionally, the funding will go toward efforts to address nurse shortages through the newly established UH Health program. The Hamill Foundation has donated $6 million previously to UH through the years, but the latest $1 million is the largest single investment from the foundation to date.

“The Hamill Foundation continues to help us raise the bar for nursing education and address the nursing shortage,” Kathryn Tart, founding dean and professor at Gessner College and Humana Endowed Dean's Chair in Nursing, said in a news release. “The enduring commitment and generosity of The Hamill Foundation allow us to answer the call and educate generations of competent and caring nursing professionals.”

Both of the recent gifts help fund UH’s $1 billion Can’t Stop Houston: The Centennial Campaign. As of September, the university had raised more than $881 million. UH turns 100 years old in March 2027.

SpaceX's supersized Starship rocket launches into orbit for first time

Out in Space

SpaceX launched its enormous Starship into orbit for the first time Monday, September 28, and successfully delivered the most advanced Starlink satellites yet, but cut the flight short to ensure safety.

The spacecraft reentered over the Pacific and splashed down north of Hawaii three hours after blasting off from Texas. The company had been aiming for a 10-hour flight, spanning six full laps around Earth, to prove its readiness for NASA’s Artemis moon program.

Starship tipped over and erupted in flames upon splashdown, a dramatic end to the mission.

Elon Musk's Starship almost didn't make it to orbit when one of its engines shut down prematurely. But with everything else working well and the bad engine no longer needed, flight controllers decided, after several tense minutes, to proceed as planned.

“Starship is orbital,” Mission Control announced to cheers.

NASA Administrator Jared Isaacman congratulated SpaceX on reaching orbit and “managing every step in a safe, responsible and especially inspirational way.”

Rocket carries 26 of Musk's most advanced Starlink satellites

Musk’s showpiece rocket — the biggest and most powerful ever built — carried 26 of the latest Starlinks to join the 11,000 older models already providing internet service. They popped out of the spacecraft one by one, drawing more cheers from the SpaceX crowd at the Starbase launch site.

The decision to end the flight early came soon afterward. SpaceX said hours later in an online update that the decision was made “out of an abundance of caution” because of the early engine trouble.

It was Starship’s 14th full-scale launch from Texas’ southern tip in three years. Earlier test flights ventured no farther than the Indian Ocean halfway around the world, often crashing in flames and briefly skimming space.

This time, the intent was for SpaceX to circle the globe from an altitude of 170 miles (275 kilometers) — not just once but six times over almost 10 hours, ending with a Pacific splashdown near Chile. While Starship achieved the proper orbit, zipping along at 17,500 mph (28,000 kph), flight controllers opted to play it safe and bring it back several hours sooner, after just a couple of laps.

The first-stage booster was never meant to return to the Starbase launch site either, dropping instead into the Gulf of Mexico within minutes of the morning liftoff.

SpaceX wants to ensure that everything works before flying Starship back to Starbase. If the spacecraft breaks apart over land and rains debris onto people, “our popularity would diminish very rapidly,” Musk said at a business summit earlier this month. “That’s why we’re being extremely cautious here.”

Depending on the findings from Monday's orbital debut, the next Starship could return to the launch pad, where giant mechanical arms would grab the hovering spacecraft. If the catch works — Musk gives it even or slightly better odds — then SpaceX will refly the spacecraft by year’s end or early next year.

The 407-foot (124-meter) rocket was designed from the start to be fully reusable, a key to lowering launch costs. SpaceX managed to salvage the last Starship from the Indian Ocean in July. Engineers modified the newly launched Starship’s heat shield based on hands-on inspections of the recovered spacecraft, which is being tugged back to Starbase.

SpaceX wants Starship to be certified for orbital flight

SpaceX is pressing hard to certify Starship for orbital flight, a vital step toward moon and Mars travel.

NASA’s Artemis III mission is coming up as soon as next summer, a triple-launch docking exercise in orbit around Earth between an Orion capsule full of astronauts and competing lunar landers. Jeff Bezos’ Blue Moon would blast off first, followed by Orion — which would close in for a linkup — and then Musk’s Starship for a docking with Orion once Blue Moon is unleashed.

The next mission, Artemis IV, is slated for no sooner than 2028 and would have astronauts landing on the moon in either Blue Moon or Starship, whichever is ready first. Subsequent moonshots will alternate between the two billionaires’ landers.

Musk originally developed Starship for Mars, intending to launch scores of them with the red planet’s first settlers. For now, he plans to focus on the moon and use Starship to haul satellites into orbit by the truckload, phasing out the company’s frailer Falcon 9 rocket within several years. A second Starship launch site is nearing completion at Florida’s Kennedy Space Center and a third is planned for Louisiana.