Nearly a quarter of Texans are without health insurance, again the highest rate in the country.

Current Population Survey estimates released Tuesday by the U.S. Census Bureau showed 24.6 percent of Texans lacked health insurance last year, even as the national uninsured rate declined from 15.4 percent to 15.1 percent.

About 48 million Americans, including more than 6 million people in Texas, were uninsured in 2011 and 2012, according to the survey.

The rate of Americans with insurance coverage who were enrolled in government health programs, such as Medicare or Medicaid, increased for the sixth straight year, to 36.2 percent in 2012.

Nearly 64 percent of those with insurance coverage purchased private coverage, remaining steady from the year before.

More than 1 million Texas children lack health insurance, but the majority of uninsured Texans were adults between 18 and 65 years old.

Gov. Rick Perry restated his opposition Monday to expanding Medicaid to low-income adults and directed the state agency that oversees the program to seek permission to reform it instead.

Perry asked the agency to seek a waiver to allow the state to make changes without federal approval.

If Texas had expanded Medicaid eligibility under the Affordable Care Act, the program could have extended coverage to more than 2 million people, according to a study by the state’s former deputy comptroller and fiscal consultant.