This posting describes uncompensated care in Texas and Uncompensated Care Pools that offset some of these costs. These concepts are a critically important piece of the Texas health care system, defining costs and payments associated with the uninsured and low Medicaid reimbursement rates. Because Texas has the highest proportion of uninsured individuals in the nation (17 percent) and it has elected not to expand Medicaid per the Affordable Care Act (ACA), it shoulders high uncompensated care (UC) costs.