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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Meet the esteemed judges for the 2026 Houston Innovation Awards

Meet The Judges

Editor's note: Judging is now underway for the 2026 Houston Innovation Awards, and it's time to meet the decision makers.

Our 2026 judging panel comprises past award winners who represent a variety of industries and areas of expertise. They are joined by InnovationMap's interim editor. All are deeply engaged in the Houston innovation ecosystem.

Our judging panel will review all nominee applications submitted across 10 prestigious categories. They will determine the 2026 finalists in all categories, and they will select the winners in all but one category — our people's choice award for Startup of the Year.

The sixth annual Houston Innovation Awards program will be presented in an all-digital format in 2026. We will announce this year's finalists and feature their stories throughout our special editorial series this fall. Then, stay tuned as we reveal the 2026 Houston Innovation Awards winners on InnovationMap.com in mid-November.

Sagar Dalal, Fervo Energy, 2025 Scaleup of the Year

Sagar Dalal

Sagar Dalal serves as chief of staff at Fervo Energy, a company pioneering the commercialization of next-generation geothermal power. In this role, he helps translate the CEO’s vision and priorities into execution, leading cross-functional strategic initiatives that support the company’s growth and operations.

Dalal brings nearly eight years of experience in structural engineering and project management from his time at Thornton Tomasetti and Tesla, where he engineered and built a wide range of infrastructure projects ranging from stadiums to manufacturing facilities. He holds an MBA from Stanford University and an MS in Civil Engineering from Texas A&M University. He is also a licensed professional engineer.

Aaron Fitzgerald, Mars Materials, 2025 Minority-founded Business of the Year

Aaron Fitzgerald

Aaron Fitzgerald is a three-time founder and carbon removal entrepreneur focused on reimagining how we make things. As the CEO of Mars Materials, he leads a team working to commercialize technologies that sequester captured carbon into industrial supply chains.

His vision for a defossilized future is shaped by a unique path through both policy, including a tenure in the United States Senate, and deep carbontech, with fellowships at The Lewis Latimer program, Breakthrough Energy, Prime Coalition, and Carbon 180.

Tatiana Fofanova, Koda Health, 2025 Health Tech Business of the Year

Tatiana Fofonova

Tatiana Fofanova, PhD, is the co-founder and CEO of Koda Health, an AI-enhanced patient decision support platform designed to make advance care planning (ACP) scalable, accessible, and patient-centered for patients with serious illness.

After earning her PhD in Translational Medicine at Baylor College of Medicine, she joined Texas Medical Center (TMC) as a Founder-in-Residence. It was there that she and her co-founders identified one of the most overlooked yet critical gaps in healthcare: the lack of meaningful, accessible advance care planning. Under her leadership, Koda Health now supports over 1 million patients through partnerships with organizations like Cigna, Privia, and Houston Methodist.

Lawson Gow, Greentown Labs, 2025 Incubator/Accelerator of the Year

Lawson Gow currently serves as chief strategy officer for Greentown Labs, which was named Incubator/Accelerator of the Year in the 2025 Houston Innovation Awards. Prior to joining Greentown Labs as Head of Houston in 2025, Gow was as a managing partner at Helium Capital, an investment and advisory firm that aims to support founders across the entire lifecycle of entrepreneurship.

He is also the founder of The Cannon, an innovation-infrastructure provider that operates a growing network of innovation hubs for its community of startups, entrepreneurs, investors, and corporate innovators.

Sarah Hein, March Biosciences, 2025 Female-founded Business of the Year

Sarah Hein

Sarah Hein is the founding CEO of March Biosciences, a clinical-stage cell-therapy company targeting challenging malignancies. Prior to cofounding March Biosciences, she was the founding Entrepreneur in Residence for the Texas Medical Center Innovation Accelerator for Cancer Therapeutics (TMCi ACT).

Formerly, she was a cofounder and the vice president of operations at Courier Therapeutics, a cancer immunotherapy startup acquired by Valo Health. She was also director of research at Resonant Therapeutics, an antibody therapeutics platform technology company. She began at Mercury Fund as a Venture Fellow directly after graduating with her PhD in Molecular Biology from Baylor College of Medicine.

Tanu Jain, FlowCare, 2025 Startup of the Year

Tanu Jain

Tanu Jain is a product executive, entrepreneur, founder and CEO of FlowCare, and registered nurse with a track record of building products from zero to global scale. She previously led product at BioIQ before founding FlowCare, a Houston-based period care infrastructure platform making period care a standard in every restroom. In under 16 months, FlowCare has signed deployed across four enterprise customers and impacted more than 1.5 million women.

FlowCare was named Startup of the Year at the 2025 Houston Innovation Awards, and Jain has been recognized with additional honors including the SDG Super Changemaker – Pewter — at the Global Sustainability Awards 2026.

Prabhdeep "Prab" Sekhon, Eclipse Energy, 2025 Energy Transition Business of the Year

Prabhdeep Singh Sekhon

Prabhdeep Singh Sekhon is CEO of Eclipse Energy, an energy technology company transforming depleted oil fields into low-cost, sustainable hydrogen resources through subsurface biotechnology. He brings nearly two decades of global energy experience spanning climate technology, venture capital, private equity, and multi-billion-dollar energy projects across five continents.

Previously, he held leadership roles at NextEra Energy Resources and Hess Corporation. He is also a founder and managing director of GreenLite Resources and a founding member of Cotogna Sports Group. He holds an MBA from Wharton, a Masters in Engineering from Texas A&M, and a BS from the University of Calgary.

Wade Pinder, Product Houston, 2025 Trailblazer Award Winner

Wade Pinder thinks of himself as an "ecosystem wayseeker," helping founders and builders in and around Houston find their footing, understand the landscape, and move through uncertainty with more clarity. Through Product Houston, he works at the intersection of product strategy, founder support, ecosystem mapping, and community-building, with a particular focus on helping people show up in the right rooms before they feel fully ready.

His background includes years in product management at Blinds.com and Home Depot, along with founding and leading the Houston Product Community for six years. He was recognized by as Mentor of the Year in the 2023 Houston Innovation Awards and received the Trailblazer Award in 2025.

Laura Furr Mericas, Interim Editor, InnovationMap

Laura Furr Mericas is interim editor for InnovatonMap.com and EnergyCapitalHTX.com. She is a longtime contributor to both sites and has reported on Houston's innovation ecosystem for InnovationMap since 2020. Previously, she served as web editor and data reporter for Houston Business Journal.

Report: Income for top 1 percent earners in Texas has surged in 2026

money matters

In a state where local billionaires are wealthier than they've ever been, high-earning Texans need to make $73,000 more than they did a year ago if they want to be among the top 1 percent of earners, a new report has revealed.

SmartAsset's study analyzed income thresholds for the top 1, 5, and 10 percent of earners in all 50 states and the District of Columbia, using 2022 IRS data for individual tax return filers (the most recent year available), adjusted to 2026 dollars.

Texas has the 11th highest income threshold, with residents needing to make a minimum of $817,158 to be considered among the top 1 percent of earners statewide. In 2025, Texans needed to make about $744,000 to be among the top 1 percent.

For comparison, residents living in the nation's capital must make at least $1.16 million to qualify as top 1 percent earners. The District of Columbia led the nation with the highest income threshold to be a top earner.

To be considered among the top 5 percent of earners in Texas, a resident would need to make $312,671. The income threshold to be considered among the top 10 percent is $210,609.

SmartAsset additionally found that 128,130 Texas residents qualified as top 1 percent earners in 2022. Nationally, the report estimated that fewer than 2 million households earn enough to be considered among the top 1 percent of earners nationwide, but 23 million households rank among the top 10 percent.

"In some places, households can enter the top 1 percent at income levels that fall well below the threshold elsewhere, reflecting an uneven landscape of wages and wealth," the report said.

A separate SmartAsset study that tracked the upper and lower thresholds for middle class households found Houston residents need to make anywhere from $42,907 to $128,722 to maintain their middle class status.

The top 10 states with the highest thresholds to be considered in the top 1 percent of earners in the U.S. are:

  • No. 1 – District of Columbia ($1,156,664)
  • No. 2 – Connecticut ($1,147,898)
  • No. 3 – Massachusetts ($1,006,921)
  • No. 4 – California ($987,325)
  • No. 5– New Jersey ($969,976)
  • No. 6 – New York ($959,562)
  • No. 7 – Florida ($956,449)
  • No. 8 – Washington ($903,303)
  • No. 9 – Colorado ($828,772)
  • No. 10 – Wyoming ($819,014)
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This article originally appeared on CultureMap.com.

Here’s where wages grew the most in Houston since 2021, according to new report

pay raise

Bolstered by a thriving manufacturing sector, Waller County—the country’s second-fastest-growing county—leads all Houston-area counties for the growth of pay from 2021 to 2026, according to a new study.

The study, conducted by personal finance website SmartAsset, found average pay in Waller County rose 48 percent from 2021 to 2026. The county’s average weekly pay climbed from $891 to $1,323 during that period.

Manufacturing ranks as the No. 1 employment sector in Waller County, accounting for about 4,500 workers, according to Executive Pulse. Those workers earn an average pay of $77,442 per year.

Waller County powers up its manufacturing hub

Waller County’s manufacturing economy keeps expanding, almost certainly contributing to the 48 percent spike in average pay from 2021 to 2026.

Grundfos, the world’s largest producer of water pumps, broke ground in June on a manufacturing plant at its Brookshire campus. The Danish company’s U.S. headquarters is in Brookshire. In conjunction with the groundbreaking, Grundfos opened the Grundfos Academy Americas training center.

The new 143,000-square-foot facility will make pump systems and water technology, primarily for water utilities and commercial real estate landlords.

Grundfos expects construction to be completed by Q3 2027, with the first production lines planned to start in Q4 of next year.

“Our growing presence in Brookshire reflects both our confidence in the U.S. market and our long‑term commitment to investing where our customers and partners need us most,” Grundfos CEO Poul Due Jensen said in a release.

Another manufacturer, TMEIC Corporation America, recently opened its third U.S. plant at Twinwood Business Park in Brookshire. The 280,000-square-foot facility, which eventually might employ 500 people, makes uninterruptible power supply units and medium-voltage power drives. The $65 million plant includes a customer training center and tech development labs.

The Twinwood facility is the largest of TMEIC’s 13 factories around the world.

TMEIC’s two other U.S. manufacturing plants are in the Houston area. The company’s North American headquarters is in the Houston Energy Corridor.

Perhaps the biggest recent manufacturing prize for Waller County: Austin-based electric vehicle maker Tesla’s new 1.65 million-square-foot factory at Brookshire’s Empire West Industrial Park. The $200 million plant, expected to employ up to 1,500 people by 2028, produces utility-scale batteries for energy storage.

Other major manufacturers in Waller County include Daikin North America and Igloo.

Pay growth around the region

Here’s a rundown of 2021-26 pay growth in the Houston metro’s eight other counties, according to SmartAsset.

  • Austin County — 42 percent
  • Chambers County — 37 percent
  • Harris County — 33 percent
  • Liberty County — 31 percent
  • Montgomery County — 29 percent
  • Fort Bend County — 28 percent
  • Galveston County — 26 percent
  • Brazoria County — 23 percent

Statewide, Dickens County, outside of Lubbock, saw the most significant growth in wages. According to the study, wages grew by 212 percent over the five years, from $707 per week in 2021 to $2,204 per week in 2026.

Among all Texas counties, Waller was ranked No. 44 on the report.

Small counties in the High Plains and West Texas regions saw the largest percent changes in average weekly wage, according to the report. See the full findings here.