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.

Texas ranks worst in the nation for access to health care. Getty Images/fstop123

New study rates Texas among the 10 worst states for health care

Time for a checkup

Health care is already one of the hottest topics in the country, and a new study comparing systems at the state level offers even more to talk about — especially in Texas, which is rated one of the worst in the country.

Personal finance website WalletHub compared all 50 states and the District of Columbia in terms of access, outcomes, and costs to determine the best and worst states for health care. Texas ranks 43rd, the ninth-worst in the nation, for 2019.

The Lone Star State lands in the bottom half of the rankings for all of the aforementioned categories, coming in dead last, No. 51, for access to health care.

Texas has the lowest rates of insured children and adults in the nation, according to the study, as well as consistently low numbers of physicians, physician's assistants, and nurse practitioners per capita, all of which fall in the lowest quadrant of states studied. Alarmingly, Texas also has one of the worst EMS response times, 8.37 minutes, but it ranks surprisingly well for retaining medical residents, No. 5 overall.

Texas does slightly better, 38th, in outcomes, which considers such factors as infant mortality rate, life expectancy, and the share of patients readmitted to hospitals after being discharged. For all of those factors, the state receives middle-of-the-road rankings.

When it comes to costs, however, Texas has a couple of redeeming rankings. The Lone Star State is No. 28 overall, but it boasts the country's eighth-lowest cost of a medical visit ($97.99) and the 16th lowest average monthly insurance premium ($544). Offsetting those are its No. 32 ranking for share of out-of-pocket medical spending (11 percent) and No. 43 ranking for share of adults who haven't seen a doctor because of the cost (19 percent).

The best health care in the country, says WalletHub, is available in Minnesota. At the very bottom of the list is Alaska, the worst state for health care in 2019.

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This story originally appeared on CultureMap.com.

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Houston claims 19% of Texas’ new live-work-play growth

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In Texas, Houston is a big player in the live-work-play real estate movement.

A new 21-city analysis from coworking marketplace CoworkingCafe shows the Houston area added five live-work-play projects—mixed-use developments with residential, office and recreational components—over the past decade.

From 2016 to 2025, Houston accounted for 19 percent of Texas’ new live-work-play inventory, the analysis shows. Among the new local developments were Arrive Upper Kirby, St. Andrie, and The Laura:

Arrive Upper Kirby, which was sold in 2021 for $182 million, offers more than 61,000 square feet of retail and restaurant space adjacent to apartments and offices. The 13-story, 265,000-square-foot project was completed in 2017.
St. Andrie, a 32-acre, mixed-use community, was completed in 2019. The apartment-anchored development includes an H-E-B grocery store and 37,000 square feet of office space.
The Laura, spanning 110,000 square feet, was completed in 2023. Among the apartment complex’s amenities is a coworking space.

According to Northspyre, a software provider for real estate developers, live-work-play projects enable people to meet their needs, such as housing, workplaces, stores, restaurants, and recreation facilities, in a single place.

A total of 542 live-work-play developments opened between 2016 and 2025 in the 21 cities, with another 69 in the pipeline for 2026, CoworkingCafe says. Among major markets, New York City made up the largest share (119) of new live-work-play developments from 2016 to 2025.

The Houston area’s five projects were built in 2018, 2019, 2020, 2024, and 2025, CoworkingCafe data indicates, with another project scheduled for completion next year. The Greater Houston Partnership recently highlighted four mixed-use projects taking shape in the region, but only one of them is scheduled to be finished in 2027. It can take two to five years or more to complete a mixed-use development.

Of the five Houston developments finished in the past decade, 56 percent of the space went toward multifamily units, 29 percent toward offices, and 16 percent toward retail, CoworkingCafe says.

As noted by the Houston-Galveston Area Council, economic development in the 21st century “is about cultivating quality live-work-play environments that attract, retain, and grow a diverse and skilled population. Employers and businesses are increasingly choosing to make long-term investments in places that connect and engage people to strengthen economic competitiveness and promote innovation.”

With eight completed projects, Austin led construction of live-work-play developments in Texas from 2016 to 2025, according to CoworkingCafe. Dallas, which welcomed five live-work-play developments during that period, tied with Houston. San Antonio data wasn’t available.

Rice Business Plan Competition awards $1.4M to 2026 student teams

winner, winners

Editor's note: This article has been updated to correct the total amount of investment and cash prizes awarded at the RBPC and with additional information from Rice.

Another team from the Great Lakes State took home top honors and investments at this year's Rice Business Plan Competition.

BRCĒ, a material-tech startup from Michigan State University, took home the top-place finish and the largest investment total at the annual Houston event. It has developed Lattice-Grip technology to create utility-based polymers that can replace traditional fabric. The materials are stronger, fire-resistant and more stable than traditional textiles, according to the company. Last year, the University of Michigan's Intero Biosystems won first-place finish and the largest investment total of $902,000.

In total, the RBPC doled out more than $1.4 million in investment and cash prizes, according to Rice. Over the three-day event, held April 9-11, the 42 competing startups presented their business plans to 300 angel, venture capital and corporate investors. Seven finalists were selected.

Three Texas teams, including one from Houston, were named among the finalists. Here's who won big this year, with their investment totals and some of their awards listed below.

BRCĒ, Michigan State University — $611,500

The recent Shark Tank alum finished in first place for its utility-based polymers technology.

$200,000 Goose Capital Investment Grand Prize
$100,000 The OWL Investment Prize
$100,000 Houston Angel Network Investment Prize
$75,000 The Indus Entrepreneurs (TiE) Texas Angels Investment Prize
$50,000 nCourage Investment Network’s Courageous Women Entrepreneur Investment Prize
$25,000 New Climate Ventures Sustainable Investment Prize
$20,000 Aramco Innovator Cash Prize
$1,000 Anbarci Family Company Showcase Prize
$500 Mercury Fund Elevator Pitch Competition Prize – Consumer Hard Tech

Legion Platforms, Arizona State University — $535,500

The startup won second place for its multiplayer gaming platform that can be accessed with slow internet speeds.

$100,000 Anderson Family Fund & Finger Interests Second Place Investment Prize
$200,000 Goose Capital Investment Prize
$100,000 The OWL Investment Prize
$25,000 Pearland EDC Spirit of Entrepreneurship Cash Prize
$500 Mercury Fund Elevator Pitch Competition Prize – Consumer

Imagine Devices, University of Texas at Austin — $111,000

The pediatric medical device company won third place for its multifunction neonatal feeding tube, known as Trinity Tube

$50,000 Anderson Family Fund & Finger Interests Third Place Investment Prize
$25,000 Pearland EDC Spirit of Entrepreneurship Cash Prize
$25,000 The Eagle Investors Investment Prize
$1,000 Anbarci Family Company Showcase Prize

Altaris MedTech, University of Arkansas – $16,000

The startup won fourth place for its pain-free strep test.

$5,000 Norton Rose Fulbright Fourth Place Prize
$1,000 Mercury Fund Elevator Pitch Competition Prize — Overall Winner

Routora, University of Notre Dame & University of Texas at Austin – $15,500

The team won fifth place for its route optimization app that works to reduce fuel costs, travel time and carbon emissions

$5,000 Chevron Fifth Place Prize
$500 Mercury Fund Elevator Pitch Competition Prizes — Digital

DialySafe, Rice University — $15,500

The startup won sixth place for its technology that aims to make at-home peritoneal dialysis simpler and safer.

$5,000 ExxonMobil Sixth Place Prize
$500 Mercury Fund Elevator Pitch Competition Prizes — Life Science

Arrow Analytics, Texas A&M University – $16,000

The startup won seventh place for its AI-powered sizing system for carry-on baggage.

$5,000 Shell Ventures Seventh Place Prize
$1,000 Anbarci Family Company Showcase Prizes

Other significant prizes included:

BiliRoo, University of Michigan – $26,000

$25,000 Southwest National Pediatric Device Consortium Pediatric Device Cash Prize
$1,000 Anbarci Family Company Showcase Prizes

BeamFeed, City University of New York – $25,000

$25,000 Amentum and WRX Companies Rising Stars Space Technology and Commercial Aerospace Cash Prize

Grapheon, University of Pittsburgh — $20,000

$20,000 Aramco Innovator Cash Prize

A total of $75,000 in in-kind legal services was awarded to all finalists. The grand prize winner, BRCĒ, also received a chief financial officer consulting prize worth $40,000. Each competing startup received at least $950 in prizes for placement in the competition.

“The Rice Business Plan Competition has grown into far more than a competition—it’s a proving ground for founders and a catalyst for real company formation, as well as a catalyst for building the Houston entrepreneurial ecosystem,” Brad Burke, associate vice president of Rice Innovation and executive director of Rice Alliance, said in a news release. This year's event was Burke’s final RBPC after nearly 25 years of leadership.

Last year, the Rice Business Plan Competition facilitated over $2 million in investment and cash prizes. According to Rice, more than 910 startups have raised more than $6.9 billion in capital through the competition over the last 25 years.

See a full list of this year's winners and stream rounds from the competition here.

Here's the income it takes to live comfortably in Houston in 2026

Money Talk

2026 report analyzing how much it costs to live "in sustainable comfort" in the biggest U.S. cities has found Houston residents have the 11th lowest salary requirement to live a comfortable life in 2026.

SmartAsset's annual report found single adult residents in Houston need to make $89,981 a year to qualify as "financially stable." Compared to last year, single Houstonians needed to make $83 more to live comfortably in the city.

Families with two working parents and two children need to make a household income of $204,672 to have a financially stable life in Houston, the report found. That's almost $2,000 less than what families needed to make last year.

To determine the rankings, SmartAsset's analysts examined 100 of the largest U.S. cities and used the latest cost of living data – such as the costs for housing, food, transportation, and income taxes where applicable – from the MIT Living Wage Calculator for childless individuals and for two working adults with two children.

For the purpose of the study, the 50/30/20 budgeting strategy was used to determine "comfortable lifestyle" costs for both individuals and families: 50 percent of income to cover needs and living expenses, 30 percent for "wants," and 20 percent for savings or paying down debt.

Here's breakdown of a Houston resident's comfortable lifestyle based on SmartAsset's findings:

$44,991 dedicated to needs and living expenses
$26,994 dedicated to wants
$17,996 dedicated to savings or debt repayment

This is SmartAsset's interpretation of a comfortable lifestyle for families of four:

$102,336 dedicated to needs and living expenses
$61,402 dedicated to wants
$40,934 dedicated to savings or debt repayment

SmartAsset said single individuals and families should compare the fluctuating local cost of living and their long-term goals to fully "understand the context" of their respective household incomes. But it's worth pointing out that a financially stable life in Houston isn't quite attainable for many residents: The city had a median household income of $64,361 in 2024, according to the U.S. Census Bureau.

Comfortable salaries in other Texas cities

Elsewhere in Texas, the report found that families in the Dallas-Fort Worth suburbs Frisco and McKinney "are closest to a comfortable salary."

"In Frisco, the median household earns $145,444 – substantially higher than the national median of $83,730," the report's author wrote. "This figure also accounts for 63.1 percent of the $230,464 income a family of four in Frisco needs to live comfortably. In McKinney, TX, the $124,177 median household income accounts for 53.9 percent of the $230,464 needed."

Both cities also tied with Plano for the 29th highest salary needed nationally to live comfortably in 2026. Single adults living in these cities need to make $109,242 a year to live a financially stable life this year.

On the opposite end, San Antonio has the lowest salaries needed to live comfortably in the U.S. Single adults only need to make $83,242 a year, and $192,608 for families of four.

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