More than 18 percent of Texans are uninsured, the highest rate in the country. If you think that doesn’t affect you, think again. “Even if patients are getting free or reduced care, someone has to pay for it,”says Marah Short, associate director of the Center for Health and Biosciences at Rice University's Baker Institute. “That is raising the cost for everyone,” mainly in the form of higher insurance premiums. Texas has made the situation even more dire by refusing to accept new federal funds for Medicaid expansion, which would have allowed the state to loosen restrictions on which patients are eligible for federal assistance and take the burden off local hospitals. “We’re paying billions of dollars in the form of federal taxes,” says Short. “We could be getting billions back, but instead that money is going to other states.” Recent surveys indicate more than 60 percent of Texans favor expanding Medicaid. Maybe it’s time for the state to start listening.