When someone waits too long to seek medical treatment, a problem that was initially manageable can develop into a serious and expensive emergency.
This is the reality for thousands of uninsured individuals in Texas who put off seeking health care due to cost. Texas has the highest rate of uninsured residents in the nation, at around 20%.
Brady Harwell, executive director of the Presbyterian Medical Care Mission, said most hospitals “see patients, they provide care for them without the expectation that that individual is going to be able to cover or pay for that service. And so they have to figure out a way in which to offset those losses with those individual patients that can’t, you know, pay their bills.”
Rural hospitals especially struggle to offset the cost of uninsured patients. A recent analysis by the health consulting firm Chartis shows that in 2025, 46% of rural hospitals in the U.S. operated in the red. Since 2010, the state has led the nation in the number of these rural facilities that have closed or reduced services.
The Presbyterian Medical Care Mission serves Taylor County and 18 surrounding rural counties. Its goal is to provide uninsured and low-income patients with the necessary medical care and prescriptions before manageable problems become huge issues.
“I don’t think that enough people know that we are a resource available to folks that are on the uninsured side,” Harwell said.
Services are available to uninsured individuals who are at or below three times the federal poverty level of around $15,000.
Last fiscal year, they obtained nearly $7 million worth of medication for their patients. Being a charitable clinic, the mission can tap into benefits pharmaceutical companies have specifically for the uninsured.
“The vast majority of patients can actually have those medications directly shipped to their home. And when that takes place, we charge zero dollars. So they’re literally getting months of medications at a time, for no cost to them,” Harwell said.
In total, a visit to Presbyterian Medical Care Mission costs around $50. That covers being seen by a physician, labwork, and medications.
Lower-income residents of Taylor County are also eligible for the Abilene Public Health District's charity care program. The health district has other state-funded programs available to residents who don’t live in Taylor County.
Cari Waller, director of nursing at the health district, said we live in what is considered a family planning desert. Many women who don’t know where to start with family planning or can’t afford birth control come in for help.
“One of our more popular clinics is our women’s clinic and our STD clinic, and it is because the care is not available anywhere else,” Waller said.
STD services are accessible through the charity care program. Those above its income thresholds can still get services for a $25 co-pay.
Abilene’s Public Health District also provides breast and cervical cancer screens through the Healthy Texas Women program, plus family planning services to eligible patients aged 15-44. This state-funded program is slightly more selective, but Waller said there’s also an affordable self-pay option for patients who do not qualify for free care.
“We’re going to work you up as a case, regardless of whether you’re insured or uninsured,” Waller said.
Abilene’s health district offers several other services, like immunizations, laboratory tests, and dental care.
It’s not just this area of Texas where free or low-cost healthcare is available to the uninsured. The statewide website, https://www.211texas.org/, provides patients with a list of medical options available to them by ZIP code.
To get an appointment set up, most clinics will ask patients to provide a pay stub and some type of proof of residence or ID.