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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Report: These 10 jobs earn the biggest salary premiums in Texas

A move to Texas bolsters earnings for some, and a new SmartAsset study has revealed the top professions where the median annual earnings in the Lone Star State exceed the national median.

The report, "When it Pays to Work in Texas — and When It Doesn’t," published in April, analyzed over 700 occupations to determine which have the biggest "Texas premium" — meaning jobs where the price-adjusted median annual pay in Texas most exceeds the national median for the same occupation — and which jobs have the biggest “Texas penalty,” where the statewide median annual pay falls furthest below the national median. Salaries were sourced from the U.S. Bureau of Labor Statistics (BLS) and adjusted for regional price parity.

According to the report's findings, geoscientists have the biggest "Texas premium" and make a $159,903 median annual salary. Texas' salary for geoscientists is 61 percent higher than the national median for the same position (after adjusting for regional price parity).

"Texas’s large petroleum industry helps explain why employers in the state retain so many geoscientists," the report's author wrote. "In fact, the Lone Star State is home to more geoscientists than any other state except California."

There are more than 3,600 geoscientists working in Texas, SmartAsset said.

These are the remaining top 10 occupations with the biggest "Texas premiums" (salaries are price-adjusted):

  • No. 2 – Commercial pilots: $167,727 median Texas earnings; 37 percent higher than the national median
  • No. 3 – Sailors: $67,614 median Texas earnings; 36 percent higher than the national median
  • No. 4 – Aircraft structure assemblers: $83,519 median Texas earnings; 35 percent higher than the national median
  • No. 5 – Ship captains: $108,905 median Texas earnings; 27 percent higher than the national median
  • No. 6 – Nursing instructors (postsecondary): $100,484 median Texas earnings; 26 percent higher than the national median
  • No. 7 – Tax preparers: $63,321 median Texas earnings; 25 percent higher than the national median
  • No. 8 – Chemists: $104,241 median Texas earnings; 24 percent higher than the national median
  • No. 9 – Health instructors (postsecondary): $128,680 median Texas earnings; 22 percent higher than the national median
  • No. 10 – Engineering instructors (postsecondary): $129,030 median Texas earnings; 22 percent higher than the national media

The careers where Texas workers earn less

SmartAsset said an editor is the Texas profession where workers earn the furthest below the median for the same occupation elsewhere in the U.S. Not to be confused with film and video editors, BLS defines editors as those who "plan, coordinate, revise, or edit written material" and "may review proposals and drafts for possible publication."

The study found editors make a price-adjusted median wage of $29,710, which is 61 percent lower than the national median for the same position, and there are nearly 8,200 editors in Texas.

It's worth noting that the salaries for editors may be skewed by the fact that there are not major publications in rural areas of Texas, and other professions may also have financial deviations for similar reasons.

Several healthcare jobs also appear to have the worst penalties in Texas compared to elsewhere in the country. Home health aides are the second-worst paying professions in the state, making a median wage of $24,161.

"More home health aides work in Texas than in nearly any other state, with only California and New York employing more," the report said. "However, the more than 300,000 Texans in this occupation earn median annual pay that is about 31 percent below the national median, after adjusting for regional price parity.

SmartAsset clarified that pay penalties are not consistent "across the board" for other healthcare occupations in Texas.

"For physical therapy assistants, occupational therapy assistants, and postsecondary nursing instructors, Texas may be an especially strong place to work, with these occupations offering 'Texas premiums' of between 17 percent and 26 percent," the study said.

These are the remaining top 10 occupations where median annual earnings in Texas fall furthest below the national median for the same occupation:

  • No. 3 – Cardiovascular technicians: $49,382 median Texas earnings; 27 percent lower than the national median
  • No. 4 – Semiconductor processing technicians: $38,295 median Texas earnings; 25 percent lower than the national median
  • No. 5 – Tutors: $30,060 median Texas earnings; 25 percent lower than the national median
  • No. 6 – Control and valve installers: $56,496 median Texas earnings; 24 percent lower than the national median
  • No. 7 – Mental health social workers: $46,109 median Texas earnings; 23 percent lower than the national median
  • No. 8 – Clinical psychologists: $74,449 median Texas earnings; 22 percent lower than the national median
  • No. 9 – Producers/directors: $65,267 median Texas earnings; 22 percent lower than the national median
  • No. 10 – Interpreters/translators: $46,953 median Texas earnings; 21 percent lower than the national median

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This article originally appeared on CultureMap.com.

Houston rises in 2026 ranking of best U.S. cities to start a business

Best for Biz

Houston has reaffirmed its commitment to a business-friendly environment and now ranks as the 26th best large U.S. city for starting a business in 2026. The city jumped up eight places after ranking 34th last year.

WalletHub's annual report compared 100 U.S. cities based on 19 relevant metrics across three key dimensions: business environment, access to resources, and costs. Factors that were analyzed include five-year business survival rates, job growth comparisons from 2020 and 2024, population growth of working-age individuals aged 16-64, office space affordability, and more.

Florida cities locked out the top five best places in America for starting a new business: Tampa, Orlando, Jacksonville, Hialeah, and St. Petersburg.

Houston's business environment ranked as the 19th best in the country, and the city ranked 51st in the "business costs" category. However, the city lagged behind in the "access to resources" ranking, coming in at No. 72 overall. This category examined metrics such as Houston's working-age population growth, the share of college-educated individuals, financing accessibility, the prevalence of investors, venture investment amounts per capita, and more.

"From the Gold Rush and the Industrial Revolution to the Internet Age, periods of innovation have shaped our economy and driven major societal progress," the report's author wrote. "However, the past few years have been particularly challenging for business owners in the U.S., due to factors such as the COVID-19 pandemic, the Great Resignation and high inflation."

Earlier this year, WalletHub declared Texas the third-best state for starting a business in 2026, and several Houston-area cities have seen robust growth after being recognized among the best career hotspots in the U.S. Entrepreneurial praise has also been extended to five local companies that were named the most innovative companies in the world, and six powerhouse female innovators that made Inc. Magazine's 2026 Female Founders 500 list.

Texas cities with strong environments for new businesses
Multiple cities in the Dallas-Fort Worth Metroplex can claim bragging rights as the best Texas locales for starting a new business. Dallas ranked highest overall — appearing 11th nationally — and Irving landed a few spots behind in the 16th spot. Arlington (No. 23), Fort Worth (No. 30), Plano, (No. 35), and Garland (No. 65) followed behind.

Only six other Texas cities earned spots in the report: Austin (No. 24), Lubbock (No. 36), Corpus Christi (No. 39), San Antonio (No. 64), El Paso (No. 67), and Laredo (No. 76).

Austin tied with Boise, Idaho and Fresno, California for the highest average growth in the number of small businesses nationally, while Corpus Christi and Laredo topped a separate list of the U.S. cities with the most accessible financing.

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This article originally appeared on CultureMap.com.

Houston humanoid robotics startup taps Amazon veteran to lead manufacturing

new hire

Persona AI, a Houston-based startup that’s developing AI-powered humanoid robots for manufacturers and other businesses, has hired Brian Davis as head of global manufacturing.

Davis previously guided teams at Amazon Robotics and Dell Technologies. During his tenure at Amazon Robotics and Dell, both companies saw major increases in manufacturing volumes within a four-year period. Davis oversaw manufacturing, supply chain, logistics, quality assurance and real estate.

“Davis steps into this role [at Persona AI] as industrial enterprises face an urgent and accelerating challenge: a structural shortage of capacity for welding, fabrication, and heavy maintenance in dynamic environments, precisely the high-value, high-risk tasks where humanoid robots can deliver the greatest impact,” according to a company news release.

Davis comes aboard as Persona AI, founded in 2024, seeks to meet demand generated by deals with HD Hyundai and POSCO Group to make humanoids for shipyards and steel plants, and by a pilot program with the State of Louisiana.

“Now is the perfect time to accelerate our production capabilities as we rapidly close the gap between what’s possible in the lab versus what’s driving real commercial value,” Davis says.

“Building industrial-rated humanoid robots and production-deployable AI is only one piece of the puzzle,” he adds. “Producing humanoids at scale will require systematic supply chain management, stringent quality control, and building the playbook for safe, high-volume manufacturing. That’s what I’m here to build.”

Last year, Persona AI raised more than more than $10 million in pre-seed funding. The company also named a new head of commercial strategy in March.