Harris County spends $1.2M daily on free employee healthcare
HARRIS COUNTY, Texas (KTRK) -- Every day, Harris County says it spends $1.2 million to keep health insurance completely free for nearly 46,000 employees and retirees.
While surrounding local governments and private companies typically ask employees to split healthcare costs with employers, taxpayers continue to pay for base healthcare plans for Harris County employees.
It's an employee benefit that has doubled in price over the last decade, creating a "unique" financial challenge as the county faces a $181 million deficit and a potential 10% property tax hike to help balance the budget.
"While many employers have responded to their soaring healthcare costs by shifting the burden to employees and retirees through increased deductibles, copayments, and premiums, the County has absorbed nearly all of these costs over the past decade," according to the proposed budget book for fiscal year 2027.
Ultimately, the county's budget shows medical claims and other healthcare benefits are projected to exceed revenue and reserves by $8 million in fiscal year 2026 and $102 million in fiscal year 2027.
"If there are no changes made to benefits or employee and retiree premiums in FY27, the County's healthcare contribution would need to increase by $110 million," the county's current proposed budget shows.
Even when Harris County employees opt for a higher plan, their cost is still on the lower end compared to other major Texas counties.
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Preferred Provider Organization (PPO) premiums cost $191 for Tarrant County employees, $190 for City of Houston employees, $93 for Dallas County employees and $79 for Harris County employees who buy up to a higher plan, according to the county's budget office.
"I'd ask the viewers, how many of you ended up paying more for your health insurance last year? And I would bet it's going to be almost anybody," said Bill King, a Baker Institute fellow.
Harris County commissioners did not approve of changes to its healthcare plan that would require its employees to buy into a base plan.
But commissioners did agree to make one change to its healthcare plan that it says will impact just five employees or retirees while saving the county $9 million.
The county says this change relates to pharmacies, and they are proactively reaching out to those five impacted individuals with other pharmacies they can use to ensure the change to the plan causes minimal disruption.
"Everything I see over there, they seem to be a lot more concerned about the employees than they do the taxpayers. Now look, I'm sure the vast majority of Harris County employees do a really good job and we need them to do their job and when I was running companies, employee morale was one of the most important things," King said. "But at some point in time, you got to look at the other side of the equation. Everything you're doing to help those employees is being paid for (by) some family trying to afford a house."
Despite the increased costs, Harris County Precinct 4 Commissioner Leslie Briones called healthcare benefits a "sacred promise" that the county has made to its employees.
Precinct 3 Commissioner Tom Ramsey's office said in a statement to 13 Investigates that "Commissioners Court is working continuously to not balance the budget on the backs of retirees and employees."
Precinct 1 Commissioner Rodney Ellis told 13 Investigates in an email that while families are paying more for basic needs, like housing, food, childcare and healthcare, the county's "significant" budget shortfall is because of "state and federal attacks that have drained local governments of vital resources to meet growing needs."
"Those choices were made in Austin and Washington, D.C., but Harris County taxpayers have been forced to foot the bill, leaving fewer resources to meet the needs here at home," Ellis said in an email. "I will never support balancing the budget on the backs of working people."
Precinct 2 Commissioner Adrian Garcia suggested one cost-saving method during commissioner's court last month. He said the county could grandfather in current employees on the county's free healthcare plan while requiring new employees to pay a premium.
So far this year, Harris County has hired at least 1,750 new employees across all departments, according to county HR data. This doesn't include employees who were hired this year and have already left.
In commissioner's court last month, the county's benefits director said early estimates in one model show the county could save $540,000 in fiscal year 2027 if it required new employees to pay for basic healthcare benefits. But, she said the technology to make those changes in the county's internal system isn't easy and might not be worth the initial savings.
Still, Garcia suggested, "over time, as the workforce would presumably transition, that would be a huge savings to the county, so I do want to see how we can model that out and understand it better."
Another driver of high healthcare costs for the county is an increase in employees. The county's current payroll is $1.6 billion for about 20,800 employees.
Our investigation found there are 13 percent more employees on Harris County's payroll now compared to 2022. Meanwhile, payroll costs have increased by 51 percent, in part due to a pay parity study the county implemented that raised salaries of law enforcement and top elected officials.
"We've added a lot more employees a lot faster than the population has gone up," King said.
13 Investigates looked at Harris County departments with more than 100 employees and identified which ones had the highest percent increase in employees compared to 2022.
Our analysis used data from Harris County HR and looked at the actual number of employees on the county's payroll in May 2022 compared to May 2026, instead of just the positions that each department had budgeted for the year.
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13 Investigates reached out to the departments that saw the most growth in staffing and the majority of them said they also increased the number of services they provide residents.
Harris County Public Health Services saw the biggest percent increase in staffing, from 589 employees in 2022 compared to nearly 1,000 employees now.
Payroll costs for Public Health employees also more than doubled from 2022, with $71 million spent annually on salaries this year, according to HR data.
The department said it is transitioning away from temporary staff and contractors, and moving to more full-time public health positions, which contributed to the growth.
While the department has grown, Public Health said actual expenditures have been down the last few years, from $227 million in fiscal year 2024 compared to an estimated $182 million in fiscal year 2026.
"Over the last two years, Harris County Public Health has made significant efforts to identify efficiencies, which includes bringing programs in-house and away from vendors. Some notable examples are having Medicaid billing done in-house by Finance and bringing the Holistic Assistance Response Team (HART) into the department," Public Health said in a statement to 13 Investigates "The cost savings associated with moving HART into the department allowed the program to expand across all six Harris County Sheriff's Office districts for the budget originally allocated to three districts."
The Public Defender's Office also saw significant growth, with 128 more people than in 2022.
Chief Public Defender Genesis Draper said that growth is actually part of a long-term plan to have the public defender's office handle more criminal cases for individuals who cannot afford their own attorney.
In 2022, public defenders were appointed to nearly 16 percent of misdemeanor and felony cases, according to county data. This year, they've been appointed to 22 percent of cases.
"The county has to pay this bill regardless," Draper said. "They have to pay the bill and so they are trying to sink that money into a more cost effective and predictable way to pay for that cost"
The County Attorney's Office saw a 38 percent increase in employees since 2022.
Current County Attorney Abbie Kamin, who took office this summer, could not speak to the prior changes. But, a spokesperson for her office said in the last five years, "the county moved property tax and toll road collection services in-house, rather than paying an outside firm, resulting in 67 new positions, saving taxpayers about $8 million per year and making it easier to directly serve the people of Harris County."
Her office said it has also expanded its environmental division and has seen payroll cost increases due to more staff, healthcare costs and cost of living adjustments.
"Our work holding bad actors accountable often results in changes, but also brings fees back to the county's general fund," her office said in an email. "This fiscal year, we have been awarded more than $1 million in penalties against concrete batch plants, and County Attorney Kamin recently worked with Commissioner Garcia's office to close a tax loophole for a large oil and gas company that will add roughly $2 million annually to the tax rolls."
The Fire Marshal's Office saw a growth of 34 percent in staffing the last five years. They said most of the growth was in the Fire Code division, which is funded through the fee-supported Fire Code Fund rather than by property tax revenue.
They said department payroll increased by 57 percent, which was driven by countywide compensation mandates.
Tax Assessor-Collector Annette Ramirez took office in January 2025 so she couldn't speak to personnel decisions made prior to her appointment. But her office said some of the department's growth was due to voter registration duties moving from the Elections Administrator's Office to the Tax Office.
Since Ramirez took office, she has added 84 positions, including 20 new positions to convert temporary auto division positions to permanent positions to help process millions of auto transactions annually.
"Assessor Ramirez took office in January 2025 with a commitment to modernizing the Tax Office, making our processes more efficient, and providing a better experience for Harris County taxpayers," her office said in a statement.
Additionally, in May 2025, the county's minimum wage was raised to $20 an hour, which Ramirez's office said impacted a third of its employees.
A spokesperson for Briones' office said the wage increase allows the county to provide a "true living wage for our frontline team members."
"These include jobs like caretakers at our parks, mechanics and operators on our road and bridge crews, facilities assistants at our community centers, and skilled trades workers," the spokesperson said in an email.
Balancing the budget
Ramsey said the county is spending $1 billion more this year than it did in 2019.
To help close that gap, county leaders are looking directly at property owners and considering raising property taxes from 62 cents to 68 cents.
"You're paying 30 percent more in your property taxes than you were three years ago. Point to one thing in your life that the county has made better," King said.
Ramsey, who opposes the property tax increase, said if approved it would be the second largest in county history.
"Harris County has a spending problem, not a revenue problem. The county is spending about $500 million worth of funds towards non-statutory expenses (things that may be nice to do but not required to do). The deficit can be addressed by prioritizing statutory responsibilities," Ramsey's office said in a statement to 13 Investigates.
Harris County Judge Lina Hidalgo agrees that the county needs to reel in spending.
"We brought this on ourselves. If you decide to spend and spend and spend against the recommendations of the budget director and against the objections of some of your colleagues, eventually you have to figure out how to pay for things," Hidalgo said last month.
Hidalgo was the only member of commissioner's court opposed to recent raises that were given to all eight Harris County constables, bringing their salaries up to $305,000.
Just five years ago, the constable's salary was $133,500.
Currently, the smallest constable's office has about 87 employees and an annual operating budget of $12.4 million while the largest constable's office has more than 550 employees and a 2026 budget of nearly $60 million.
Ramsey said the state law requiring pay parity among law enforcement agencies contributed to the salary increases for law enforcement, and he sees it as an investment in reducing crime.
"With crime in unincorporated Harris County being five times less than crime in the City of Houston, the contract patrol program proves to be successful - so successful that neighborhoods choose to invest their own dollars for contract patrol," Ramsey said. "This results in $116 million coming back to the county. This is a testament to the tremendous job our law enforcement does."
Harris County commissioners will meet next Tuesday to discuss the Harris County budget and proposed tax rates.
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