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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2025 Houston Innovation Awards winners revealed at annual event

The winners are...

After weeks of anticipation, the 2025 Houston Innovation Awards winners have been revealed. Finalists, judges, and VIPs from Houston's vibrant innovation community gathered on Nov. 13 at Greentown Labs for the fifth annual event.

This year, the Houston Innovation Awards recognized more than 40 finalists, with winners unveiled in 10 categories.

2025 Innovation Awards group photo Winners gather for a photo at the annual event. Courtesy photo

Finalists and winners were determined by our esteemed panel of judges, comprised of 2024 winners who represent various Houston industries, as well as InnovationMap editorial leadership. One winner was determined by the public via an online competition: Startup of the Year.

The program was emceed by Lawson Gow, Head of Houston for Greentown Labs. Sponsors included Houston City College Northwest, Houston Powder Coaters, FLIGHT by Yuengling, and more.

Without further adieu, meet the 2025 Houston Innovation Awards winners:

Minority-founded Business: Mars Materials

Clean chemical manufacturing business Mars Materials is working to convert captured carbon into resources, such as carbon fiber and wastewater treatment chemicals. The company develops and produces its drop-in chemical products in Houston and uses an in-licensed process for the National Renewable Energy Lab to produce acrylonitrile, which is used to produce plastics, synthetic fibers and rubbers. The company reports that it plans to open its first commercial plant in the next 18 months.


Female-founded Business, presented by Houston Powder Coaters: March Biosciences

Houston cell therapy company March Biosciences aims to treat unaddressed challenging cancers, with its MB-105, a CD5-targeted CAR-T cell therapy for patients with relapsed or refractory CD5-positive T-cell lymphoma, currently in Phase 2 clinical trials. The company was founded in 2021 by CEO Sarah Hein, Max Mamonkin and Malcolm Brenner and was born out of the TMC Accelerator for Cancer Therapeutics.

Energy Transition Business: Eclipse Energy

Previously known as Gold H2, Eclipse Energy converts end-of-life oil fields into low-cost, sustainable hydrogen sources. It completed its first field trial this summer, which demonstrated subsurface bio-stimulated hydrogen production. According to the company, its technology could yield up to 250 billion kilograms of low-carbon hydrogen.

Health Tech Business: Koda Health

Koda Health has developed an advance care planning platform (ACP) that allows users to document and share their care preferences, goals and advance directives for health systems. The web-based platform guides patients through values-based decisions with interactive tools and generates state-specific, legally compliant documents that integrate seamlessly with electronic health record systems. Last year, the company also added kidney action planning to its suite of services for patients with serious illnesses. In 2025, it announced major partnerships and integrations with Epic, Guidehealth, and others, and raised a $7 million series A.

Deep Tech Business: Persona AI

Persona AI is building modularized humanoid robots that aim to deliver continuous, round-the-clock productivity and skilled labor for "dull, dirty, dangerous, and declining" jobs. The company was founded by Houston entrepreneur Nicolaus Radford, who serves as CEO, along with CTO Jerry Pratt and COO Jide Akinyode. It raised eight figures in pre-seed funding this year and is developing its prototype of a robot-welder for Hyundai's shipbuilding division, which it plans to unveil in 2026.

Scaleup of the Year: Fervo Energy

Houston-based Fervo Energy is working to provide 24/7 carbon-free energy through the development of cost-competitive geothermal power. The company is developing its flagship Cape Station geothermal power project in Utah, which is expected to generate 400 megawatts of clean energy for the grid. The company raised $205.6 million in capital to help finance the project earlier this year and fully contracted the project's capacity with the addition of a major power purchase agreement from Shell.

Incubator/Accelerator of the Year: Greentown Labs

Climatetech incubator Greentown Labs offers its community resources and a network to climate and energy innovation startups looking to grow. The collaborative community offers members state-of-the-art prototyping labs, business resources and access to investors and corporate partners. The co-located incubator was first launched in Boston in 2011 before opening in Houston in 2021.

Startup of the Year (People's Choice): FlowCare

FlowCare is developing a period health platform that integrates smart dispensers, education, and healthcare into one system to make free, high-quality, organic period products more accessible. FlowCare is live at prominent Houston venues, including Discovery Green, Texas Medical Center, The Ion, and, most recently, Space Center Houston, helping make Houston a “period positivity” city.

Mentor of the Year, presented by Houston City College Northwest: Jason Ethier, EnergyTech Nexus

Jason Ethier is the founding partner of EnergyTech Nexus, through which he has mentored numerous startups and Innovation Awards finalists, including Geokiln, Energy AI Solutions, Capwell Services and Corrolytics. He founded Dynamo Micropower in 2011 and served as its president and CEO. He later co-founded Greentown Labs in Massachusetts and helped bring the accelerator to Houston.

2025 Trailblazer Award: Wade Pinder

Wade Pinder, founder of Product Houston, identifies as an "Ecosystem Wayseeker" and is the founder of Product Houston. A former product manager at Blinds.com, he has been deeply engaged in Houston’s startup and innovation scene since 2012. Over the years, he has supported hundreds of founders, product leaders, and community builders across the Houston area. In 2023, he was honored as Mentor of the Year in the Houston Innovation Awards.

America's first Ismaili Center set to open in Houston in December

Sneak Preview

The long-awaited Ismaili Center, Houston is set to open to the public next month. The 11-acre site has been painstakingly designed and constructed to offer indoor and outdoor public spaces for Houstonians to enjoy, connect, and engage. As the only Ismaili Center in the United States — and seventh in the world — it joins its international communities in London, Vancouver, Lisbon, Dubai, Dushanbe, and Toronto.

Nearly 20 years in the making, the Ismaili Center, Houston features a prayer hall, rotating art installations, a black box theater, a cafe, numerous social halls for weddings and other events, and nine acres of outdoor space and landscaped botanical gardens. Involved parties hope that the community will see the space as an extension of the neighboring parks along the bayou, and have included a garden entrance to the north lawn and gardens at the corner of Montrose Boulevard and Allen Parkway.

While Houston is known for its many community engagement centers, the architects and designers believe that the seamless integration of indoor and outdoor spaces sets the Ismaili Center, Houston apart from all others.

“What we know is the connections between buildings, environment, quality of life, and landscape — this is nothing new,” structural and facade engineer Hanif Kara says. “But, certainly, it’s hard to see that in other developments, particularly when they are done by developers. It’s quite difficult to find community spaces, and to see how quality of life is improved for everyone. I think we’ve all experienced that kind of hope that it will play out something like this.”

Designed by Farshid Moussavi Architecture and Nelson Byrd Woltz Landscape Architects, the remarkable 11-acre site is designed both to receive LEED Gold certification and to withstand the tests of Houston’s sometimes extreme weather conditions.

Principal architect Farshid Moussavi looks forward to seeing the Houston community utilize the space she’s worked so hard to deliver: “We’ve given the hardware to the community, now the software needs to come in. So I hope that there will be music recitals, or lectures, or book fairs, or other kinds of markets that can happen—even simultaneously. This is not an experiment, it’s the seventh in the world.”

Community welcome events are scheduled for December 12 and 13, but, until then, here are 10 features and things to know about the Ismaili Center, Houston.

What is the Ismaili Center, Houston?

“The use of the building is really meant for, or our hope, is that we are able to—on an enhanced view of what the community does today—have engagement on service projects, arts and culture, interfaith dialogue, and even just in bringing people together,” Omar Samji, Ismaili Council for the United States of America, says. “The notion of bringing people together in a place where it is easy to create connections because it’s an open space, and because it’s specifically designed to be a place where people interact and where people find commonality. Because whether you’re out in the gardens, or on the environs, or in the atrium, this enables connection.”

Who is His Highness the Aga Khan?

His Highness Prince Rahim Aga Khan V is the 50th hereditary Imam (spiritual leader) of the Shia Ismaili Muslims and a direct descendant of the Prophet Muhammad. He was educated at Philipps Academy in Andover and Brown University (Class of 1995). He became Imam in February 2025 upon the passing of his father, His Highness Prince Karim Aga Khan IV.

The Aga Khan promotes an understanding of Islam rooted in values of generosity, tolerance, pluralism, environmental stewardship, and the shared unity of humanity. He also chairs the Aga Khan Development Network (AKDN), one of the world’s largest private development agencies, which works across more than 30 countries to improve quality of life for marginalized communities regardless of faith or background.

The scale

The center stretches across an 11-acre site along Montrose Boulevard, from West Dallas to Allen Parkway. The physical building is 150,000 square feet, leaving nine acres for garden spaces on both the north and south sides of the building. The south side of the property is more formal, with gardens and community spaces that flank an 80-foot reflection pool and other water features. The gardens on the north side of the building are more informal, but densely planted and vast.

Photo by Iwan Baan

The creation

The development of the Ismaili Center was led by the Ismaili Council. It was initiated by His Highness Prince Karim Aga Khan IV (1936-2025), and completed under the leadership of his eldest son, Prince Rahim Aga Khan V.

The project was designed and constructed by a team of both local and international firms. Farshid Moussavi Architecture joined forces with structural and facade engineer Hanif Kara, co-founder and creative director of AKT II. DLR Group is the architect and engineer of record, while contractor McCarthy Building Companies built the project. Thomas Woltz, senior principal and owner of landscape architecture firm Nelson Byrd Woltz, along with principal Jeff Aten taking lead on the nine acres of garden space. The project is targeting LEED Gold certification.

The focus on native Texas plants and trees

The center will be recognized as a leading cultural asset for the City of Houston, complementing nearby institutions such as The Menil Collection, Rothko Chapel, Asia Society Texas, and the Museum of Fine Arts, Houston. While the surrounding gardens will add to the other notable Nelson Byrd Woltz projects within close proximity at Memorial Park, Rothko Chapel, and Rice University.

“We’ve been building massive projects in Houston for 12 years,” Woltz says. “We know the horticultural community in the region, and we did a deep, deep dive in ecological research to understand ‘What are the native plants of whatever region?’ It’s just baked into our process. Right when we are starting any project in Houston—right to the river. Look at the soils, ‘What are the plants appropriate to that place?’ Its solar aspect, its humidity, it’s moisture in soils, the shadow of the building.

But then, this idea of taking a section across the state of Texas, so that each of those distinct ecological regions is represented by one of the terraced gardens — so it’s very clear. It’s a diagram of the state of Texas and all of its native plants. This is functioning like a botanic garden and a repository for biodiversity — this is work in service.”

The eco-friendly exterior

The exterior of the building is clad in stone, a durable material with low embodied carbon. The stone cladding is a rainscreen over in-situ ‘fair-faced’ concrete walls, exposed on the interior to minimize additional material use. The concrete mix used has replaced 35-62 percent of Portland cement with fly ash and slag, reducing CO2 emissions by roughly 30 percent compared to standard mixes. The exterior stone rainscreen uses smaller tiles to increase the stone yield, utilizing 20-25 percent more of the irregular blocks they are cut from. This reduction in waste has also lent itself to crafting the cladding in a unique way.

The tessellation of the stone pieces changes across the building's surfaces to create different patterns on different sides of the buildings and at the corners. Relief stone tiles are used to add texture to the facades.

The space for outdoor events

The north-facing botanical gardens that will accommodate the 200-year flood plain offer a 27 foot gradient toward the building. This allowed for various levels of seating and gathering areas that culminate at an elevated terrace that will act as a stage for various events such as plays and concerts. Attendees can stretch out and enjoy the shows from an extensive lawn area that is surrounded by dense gardens of native trees and plants.

The black box theater

A 2,600-square-foot black box multipurpose space which seats 125 people is found on the second floor of the building’s west wing. It can host public events, such as exhibitions, film screenings, theatrical performances, music recitals, and other artistic programs throughout the year. It will also serve as a flexible space for teaching and learning. With acoustic isolation to surrounding spaces and the mechanical mezzanine above, it is designed to operate simultaneously without disrupting other events in the building. Design includes an upper-level control room, pipe grid, and flexible drapery and seating configurations to allow for a wide variety of programming.

The cafe

The center’s café is a 1,600-square-foot, double-height space located in the west wing (Montrose side) that opens onto an enormous terrace, offering visitors the option to enjoy their coffee or food outdoors. The terrace near the cafe is lined by an exterior wall and long, trough-style fountains that aid in noise reduction from Montrose Boulevard. The second-floor wall overlooking the Café is fully glazed, creating visual connection with the levels above.

The prayer hall

The prayer hall is 12,240 square feet, featuring a unique structural system of seven interlocking squares, formed from steel beams spanning the 115-by-115-foot open space. These beams are clad in concrete to enhance durability, beneath which lies a two-layer perforated aluminum ceiling with integrated diffused lighting. Its intricate pattern recalls the traditional jālī screens of Islamic architecture creating a soft, seemingly infinite ceiling effect, adding to the serenity of the prayer hall.

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A version of this article first appeared on CultureMap.com

Intuitive Machines to buy satellite maker Lanteris for $800 million

space deal

Houston-based aerospace company Intuitive Machines has agreed to buy satellite manufacturer Lanteris Space Systems for $800 million from private equity firm Advent International.

Intuitive Machines co-founder, president and CEO Steve Altemus said the combined revenue of his company and Palo Alto, California-based Lanteris exceeded $850 million as of Sept. 30, and their backlog of orders totaled $920 million.

Until recently, Lanteris operated as Maxar Space Systems. Its origins date back to 1957.

The deal—comprising $450 million in cash and $350 million in Class A shares of Intuitive Machines stock—is expected to close in the first quarter of 2026.

The acquisition “marks the moment Intuitive Machines transitions from a lunar company to a multi-domain space [company], setting the pace for how the industry’s next generation will operate,” Altemus said.

Altemus said the acquisition would enable Intuitive Machines to better compete for Earth orbit, lunar, Mars and deep space projects. Among the opportunities that would open up thanks to the Lanteris deal are the proposed Golden Dome missile defense system and a large lunar lander capable of carrying astronauts, he said.

“The new Intuitive Machines will combine rapid innovation and precision spacecraft production to meet the growing demand for responsive, high-reliability space infrastructure and services,” Altemus said.

Intuitive Machines, founded in 2013, develops lunar landers and provides aerospace services. In 2024, it became the first U.S. company to land a spacecraft on the moon in half a century.

Altemus said Intuitive Machines is already building three satellites for NASA’s near-space network, and it might upsize two more satellites now that it plans to buy Lanteris.

Aside from satellites, Lanteris is developing the power and propulsion element for NASA’s Gateway, a lunar orbiting command module that will support Artemis missions and deep space exploration.


Lanteris was a division of Maxar Technologies, which Advent and minority investor British Columbia Investment Management took private in a 2023 deal valued at $6.4 billion

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