California-based Sidecar Health has rolled out its health insurance tech services in Texas. Images via sidecarhealth.com

The health insurance situation in Texas is anemic.

Last year, 17.7 percent of Texans lacked health insurance, according to newly released data from the U.S. Census Bureau. That's the highest rate of uninsured residents among all of the states.

The problem is even more acute in the Houston metro area. In 2018, nearly 1 in 5 residents of the region (18.6 percent) had no health insurance, the Census Bureau says. That's the highest rate of uninsured residents among the country's 25 most populous metro areas.

If you do the math, that translates into more than 5 million residents of Texas, including more than 1.3 million in the Houston area, who have no health-insurance safety net. A startup called Sidecar Health is setting out to reduce those numbers.

Texas recently became the first market for Sidecar Health's insurance plans, which it promotes as being "personalized" and "affordable." By the end of this year, the El Segundo, California-based company hopes to enroll at least 5,000 Texans.

Just as with subscription services like Netflix and Amazon Prime, a consumer can sign up for or cancel their Sidecar Health plan at any time. A member can lock in their Sidecar Health rate for three years.

Technically, Sidecar Health isn't an insurance company. Rather, it manages the insurance plans that it sells.

"Sidecar Health is different from traditional insurance in that we pay a fixed amount for any medically necessary service or prescription drug that you buy," the company explains on its website. "That means if your provider charges more than that fixed amount, you pay the difference. And if your provider charges less, you keep the difference."

Through Sidecar Health, a consumer can visit any healthcare provider, healthcare facility, or pharmacy they choose, as long as self-paying patients with credit cards or debit cards are accepted. This setup allows "complete transparency and control over healthcare costs," says Patrick Quigley, the startup's CEO.

"We make this possible by enabling our members to pay for care when they get it using the Sidecar Health payment card. Because doctors get paid immediately, they offer huge discounts. On average, it is 33 percent or more cheaper than what they charge big insurance companies," Quigley tells InnovationMap. "And because our members are doing the buying by swiping the card, they know what things cost. So you get true transparency and affordability — the way health insurance should be."

Through the Sidecar Health app, a member can see how much healthcare providers in their area charge, enabling them to compare prices.

"Our approach results in a truly affordable option for the millions of people left behind by the traditional model — those who don't qualify for a government subsidy but can't afford the cost of traditional plans," Quigley says in a release.

Sidecar Health is operating throughout Texas without any employees or offices in the state. The company sells its product directly through its website. On the website, consumers can educate themselves on available insurance plans before signing up online. Its Texas insurance plans are underwritten by Eatontown, New Jersey-based United States Fire Insurance Co., part of insurance conglomerate Crum & Forster.

Since its founding in 2018, Sidecar Health has raised $18 million in funding, led by San Francisco-based GreatPoint Ventures and Los Angeles-based Morpheus Ventures.

The startup's offering "is a great example of taking an otherwise complex process and making it simple, which is why Sidecar Health is such a game changer in health insurance," says Joseph Miller, managing partner of Morpheus Ventures.

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How Houston's cost of living compares to other major Texas cities in 2025

Calculating Costs

A new cost-of-living index yields a result that many Houstonians will find surprising: Houston is not the most expensive place to live in Texas. Dallas and Austin are costlier.

Numbeo’s cost-of-living index for 2025 shows Dallas ranks first in Texas and 24th in North America, landing at 65.8. The cost-of-living index compares the cost of living in New York City (which sits at 100) with the cost of living in another city. Austin is at 61.7, Houston at 60.6, and San Antonio at 58.8.

Houston ranks 40th overall in North America, out of 52 cities in the index.

Numbeo’s cost-of-living index takes into account the cost of items like groceries, restaurant meals, transportation, and utilities. The index excludes rent.

When rent is added to the cost-of-living index, Houston is still third among Texas cities. Dallas grabs the No. 21 spot in North America (57.1), one notch above Austin (56.6). Houston ranks 35th (51.4), and San Antonio ranks 42nd (34.6).

Rent index
While Dallas holds the top Texas spot on Numbeo’s overall cost-of-living index, Austin faces the highest rent prices. Numbeo's rent index for Austin sits at 50.1, putting it in 12th place among major cities in North America and highest in Texas, above the indexes for Dallas, Houston, and San Antonio. Houston lands at 27th.

The rent index in New York City, which tops the list, is 100. As Numbeo explains, the rent index estimates the cost of renting an apartment in a city compared with New York City. If the rent index is 50, for example, this suggests the average rent in that city is 50 percent below the average rent in New York City.

Around Texas, the rent index is:

  • 46.2 in Dallas
  • 39.8 in Houston
  • 34.6 in San Antonio

Restaurant index
In contrast to its showing on the rent and cost-of-living indexes, Houston outranks Dallas, Austin, and San Antonio on Numbeo’s restaurant index. This index compares the prices of meals and drinks at restaurants and bars to those in New York City.

Houston sits at No. 25 on the restaurant index, at 68.9. Dallas comes in at No. 32 (67.1), Austin at No. 34 (66.6), and San Antonio at No. 36 (65.2).

The National Restaurant Association reported in December that menu prices in the U.S. had risen 3.6 percent in the past 12 months, outpacing gains in grocery prices and the federal government’s overall Consumer Price Index. Fortunately for diners, that was the smallest 12-month increase in menu prices since August 2020, according to the association.

Toast, which provides a cloud-based restaurant management system, says the higher menu prices reflect higher food prices.

“Food prices have been increasing due to inflation, labor expenses, fuel costs, and supply chain disruptions, all of which impact restaurant profitability, Toast says. “While raising menu prices is one option to combat rising food costs, some restaurants have introduced service charges and simplified menus to avoid passing all costs onto customers.”

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This story originally appeared on our sister site, CultureMap.com.

Houston startup taps strategic partner to produce novel 'biobased leather'

cleaner products

A Houston-based next-gen material startup has revealed a new strategic partnership.

Rheom Materials, formerly known as Bucha Bio, has announced a strategic partnership with thermoplastic extrusion and lamination company Bixby International, which is part of Rheom Material’s goal for commercial-scale production of its novel biobased material, Shorai.

Shorai is a biobased leather alternative that meets criteria for many companies wanting to incorporate sustainable materials. Shorai performs like traditional leather, but offers scalable production at a competitive price point. Extruded as a continuous sheet and having more than 92 percent biobased content, Shorai achieves an 80 percent reduction in carbon footprint compared to synthetic leather, according to Rheom.

Rheom, which is backed by Houston-based New Climate Ventures, will be allowing Bixby International to take a minority ownership stake in Rheom Materials as part of the deal.

“Partnering with Bixby International enables us to harness their extensive expertise in the extrusion industry and its entire supply chain, facilitating the successful scale-up of Shorai production,” Carolina Amin Ferril, CTO at Rheom Materials, says in a news release. “Their highly competitive and adaptable capabilities will allow us to offer more solutions and exceed our customers’ expectations.”

In late 2024, Rheom Materials started its first pilot-scale trial at the Bixby International facilities with the goal of producing Shorai for prototype samples.

"The scope of what we were doing — both on what raw materials we were using and what we were creating just kept expanding and growing," founder Zimri Hinshaw previously told InnovationMap.

Listen to Hinshaw on the Houston Innovators Podcast episode recorded in October.