The Texas Legislature begins its 80th session Tuesday. Leaders will face numerous urgent issues, but one they must address is health care.

This is the least insured state in the country, with 25 percent of Texans lacking health care coverage.

The vast majority of those 5.6 million people work or live in a home where someone is employed — or, more accurately, "underemployed" and unable to afford health coverage.

More money must be put into the system.

In addition to expanding coverage under Medicaid and the Children's Health Insurance Program, the Legislature should consider imposing a tax on hospitals and other medical facilities.

Called a "quality assurance fee" or provider tax, a levy of 3 percent would raise about $1.1 billion, according to last year's Code Red report produced by a broad-based task force on health care.

That $1.1 billion could then be used to draw down a federal match of about $1.7 billion. That's nearly $3 billion available for health care.

If a provider tax were levied, as it is in 35 states, strict guidelines would have to regulate how the money is used. Texas has a habit of raising money for one purpose and using it for another. Providers need a guarantee that the fee would be used as intended.

Although the tax would adversely impact revenues in the short term, hospitals would benefit in the long run. In 2003, Texas hospitals provided $7.7 billion in uncompensated care.

Small businesses are the backbone of Texas' economy, yet many cannot afford to provide insurance to employees. Others offer coverage, but premiums are out of reach for workers.

Government can lend a hand.

One option is to allow small businesses to buy insurance through larger pools, which would reduce their cost and expand their choice.

Another possibility listed in the Code Red report is providing certain incentives and favorable tax policies to businesses that provide health insurance.

It's unacceptable that 2,500 uninsured Texans die prematurely each year. And it's an outrage that 1 million uninsured and chronically ill Texans don't get the treatment they need.

Eventually, that burden falls on insured Texans and all taxpayers in the form of higher premiums and costly emergency room visits, paid for by property taxes.

Larger counties, such as Bexar, bear the brunt of the uninsured from smaller, poorer nearby counties.

The Texas population is booming, and the problem will surely worsen. The time to act is now.