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

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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.

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New Texas Stock Exchange officially begins trading in Dallas

Welcome to Y'all Street

Two-step aside, New York Stock Exchange and Nasdaq. The Dallas-based Texas Stock Exchange, nicknamed Y’all Street, just kicked off live trading with five stocks — and lots of Lone Star ambition.

“The Texas Stock Exchange aims to revitalize competition for [stock] issuers, establish the premier venue for listings, and create a world-class trading platform for all market participants,” the exchange says in a fact sheet.

The exchange — whose Texas-influenced nickname is a nod to New York City’s Wall Street — has collected at least $275 million in investments. The roughly 90 financial backers of TXSE include Bank of America, BlackRock, Charles Schwab, Citadel Securities, Dell Family Office, Fortress, Goldman Sachs, and JPMorgan Chase.

Representatives of TXSE couldn’t be reached for comment. On its website, the exchange calls itself “the most well-capitalized equities exchange to ever be approved” by the U.S. Securities and Exchange Commission (SEC).

Not to be outdone, NYSE has launched Dallas-based NYSE Texas and Nasdaq has expanded its presence in Dallas.

Y’all Street adds to Dallas-Fort Worth’s rising status as a major hub for financial services, with The Wall Street Journal naming North Texas the country’s second biggest financial hub after New York City.

“A homegrown national exchange means more jobs, more investment, and more growth opportunities for businesses and communities across the Lone Star State,” Gabriela von zur Muehlen, senior vice president and chief policy officer at the Texas Association of Business, told The Texas Tribune.

Bulent Temel, an associate professor of practice in economics at the University of Texas at San Antonio, told Texas Standard that TXSE “is going to boost the credibility of the Texas economy.”

Texas’ estimated gross domestic product (GDP), a yardstick for the size of an economy, climbed to a record-setting $2.9 trillion in 2025, making it the state with the second highest GDP after California. DFW’s estimated GDP in 2023 stood at $744.6 billion, eclipsing the GDP of many countries.

“The center of gravity for American capitalism is now headquartered in the Boom Belt,” Abbott proclaimed in April, referring to an 11-state region (including Texas) in the South and Southeast that’s seeing tremendous economic and population growth. “The Texas Stock Exchange is the natural extension of that capitalism. It ensures that capital markets will reflect the quadrant that is driving American growth.”

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This article originally appeared on CultureMap.com.

Orion vehicle manager reflects on Artemis II, looks to 2028 moon mission

Q&A

Humanity is finally headed back to the moon after more than half a century. This year's launch of the Artemis II mission in the Orion spacecraft put four crew members in lunar orbit and tested the new ship developed by Lockheed Martin.

Everything went smoothly, safely returning astronauts home, but there is always room to improve. InnovationMap chatted via email with Orion vehicle manager Branelle Rodriguez, shortly after a talk at The Ion, for insight on how Orion might perform in the future as the next lunar landing approaches in early 2028.

InnovationMap: How satisfied are you with the way Orion operated on this past mission?

Branelle Rodriguez: Orion performed exceptionally well during Artemis II, successfully demonstrating critical spacecraft capabilities, including life support systems, displays and controls, and executing manual piloting operations. Artemis II brought humans back to the moon, achieving key exploration and scientific imagery, while validating systems essential for future Artemis missions.

IM: What is the most important thing you learned about improving Orion for the next mission?

BR: The Artemis II mission provided invaluable insights into crew operations and spacecraft performance in a deep-space environment. With every mission, NASA applies lessons learned to continuously improve Orion’s operations, validate design and ensure mission readiness. Artemis II offered our first opportunity to evaluate several new systems and gain a deeper understanding of what it is like for astronauts to live and work inside the spacecraft. The operational, technical and human factors data collected are being integrated across the program to refine future missions, reduce risk and enhance overall mission success.

IM: How has Orion helped the mission to explore space?

BR: Orion is one of NASA’s foundational elements for human deep space exploration—not only supporting the mission but serving as a core component of it. It is currently the only spacecraft capable of carrying crew on deep space missions and returning them safely to Earth from the high speeds required from the vicinity of the moon. No other spacecraft has the technology to endure the extremes that come with human deep-space travel, such as advanced environmental and life support, navigation, communications, radiation shielding, and the world’s largest ablative heat shield to protect the astronauts during reentry into Earth’s atmosphere. Orion has already taken astronauts to explore space farther than ever before—252,756 miles from Earth— and will carry crews to the moon on future missions to explore the lunar South Pole region. The astronauts’ observations, samples, and data collected on these future missions will expand our understanding of our solar system and home planet.

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This conversation has been edited for brevity and clarity.

Houston VC funding nears $1B in first half of 2026, report says

by the numbers

Despite a weak second quarter, venture capital funding for Houston-area startups approached $1 billion in the first half of 2026, the region’s highest first-half total since 2022, according to the latest PitchBook-NVCA Venture Monitor.

This year’s first-half total of $962.4 million represented a nearly 8 percent increase over last year’s first-half total of $891.7 million. Dating back to 2016, this year’s first-half haul lags behind only 2021 and 2022 for the most first-half funding.

Houston’s year-over-year VC jump of 73 percent in the first quarter of 2026 more than made up for the year-over-year drop of 34 percent in the second quarter of 2026, according to the report.

Deal count tells a more encouraging story: Houston startups closed 102 deals in the first half, up from 93 a year earlier and the region’s busiest first half since 2022. However, the average deal size shrank, as no single funding source dominated the total.

Keep in mind that PitchBook and NVCA routinely revise quarterly numbers upward to reflect deals that were reported after a previous quarter’s data was published. So, in the case of Houston, numbers initially reported for the first quarter of 2026 may not match newly reported numbers.

Perhaps the most notable Houston-area deal announced in the first half of this year was Cart.com’s $180 million growth equity investment, led by Springcoast Partners. Cart.com is an e-commerce platform and logistics provider.

PitchBook-NVCA data shows Houston’s VC activity is growing modestly, delivering better numbers in the first half of 2026 versus 2024 and 2025, but it still sits below the highs of 2021 and 2022. This is one sign that so far in 2026, the national VC boom isn’t benefiting non-hub markets like Houston the way it’s boosting some hub markets, especially Silicon Valley and New York City.

Nationwide, AI dominated VC funding in the first half of this year. The sector made up 86 percent of VC from January through June. The report notes that the markets have still struggled to unlock IPOs, with SpaceX being the biggest exception, and few M&A deals outside health care have been significant.

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