For years, our health care system was unfair. Insurance companies charged too much for coverage that was full of holes. Our country had enough, and we demanded a better system. Thanks to the Affordable Care Act’s (ACA) important first steps, hundreds of thousands of Texans now have the security of quality, affordable health care. For millions of other Texans that already had coverage, the law has improved it, requiring insurance companies to cover essential health benefits like prescription drugs and mental health services and preventing those companies from kicking you off coverage when you get seriously ill.
Unfortunately, our state has refused to accept billions in federal funding to expand access to quality, affordable health care to all Texans, leaving about one million hardworking Texans in the coverage gap. Other states are getting billions while Texans continue to struggle. So there’s still work to do.
This Ellis Email Express will share information on new health insurance options available to you and your family, update you on what still needs to be done to provide all Texans coverage, and share some of my health legislative priorities for this session.
New Health Insurance Options
Texas has the highest uninsured rate in the nation with nearly one in four lacking coverage, or more than 5 million people. In Houston, nearly one in three people are without health insurance, and lack of coverage makes it hard for Texas families to get the health care they need.
In fact, study after study has shown that one of the best ways to protect and improve the health of families is by expanding access to quality health insurance. Children do better in school and miss fewer days when they have health insurance. Parents and guardians can also provide a more consistent environment for their children to grow up in when the whole family is healthy.
In Texas, over 730,000 people selected a plan during the first ACA open enrollment period. Texans currently have another opportunity to enroll in coverage as the Health Insurance Marketplace will remain open until February 15, 2015. If you are eligible and don’t get covered, you might have to pay a fine of $325 per adult and $162.50 per child or 2 percent of your income (whichever is greater).
Financial help is available for individuals and families between 100-400 percent of the federal poverty level ($11,670 to $46,680 for individuals or $23,850 to $95,400 for a family of four). Eighty-four percent of people in our state who previously received coverage through the exchange received help paying for their insurance. In addition, health insurance on the exchange is affordable, as the average monthly cost for those who enrolled in coverage in Texas is $72.
Plans purchased on the exchange will also have new consumer protections and cover all ten essential benefits such as emergency services, prescriptions drugs, and preventive care. Many of these preventive services are covered with no additional costs to consumers.
Information about where to get free local in-person assistance, new health insurance plans, and how to apply for Medicaid and the Children’s Health Insurance Program can be found at links on www.enrollgulfcoast.com or by calling 832-393-5423.
Closing the Coverage Gap
While this is exciting news, we still have more work to do to ensure that all Texans have access to quality, affordable health care. Expanding access to health insurance is such an important issue that I worked tirelessly to amend Medicaid expansion language onto every bill possible this past session.
Unfortunately, the Legislature failed to take action or provide an alternative plan to cover our most vulnerable populations, leaving about a million Texans with incomes below the federal poverty level without affordable health insurance options. These are low-wage working adults who make too much to qualify for Medicaid and too little to get a subsidy on the exchange. An individual making less than $11,670 or a family of four making less than $23,850 will fall into this coverage gap.
Many Texas workers in retail, food service, health care, and construction fall into this gap. In addition, Texas also has the highest number of uninsured veterans and veterans’ spouses in the country with around 200,000 uninsured.
Providing these uninsured Texans with health coverage makes good sense for the health of our communities and the state, and it also makes good business sense. For an investment of $15 billion, Texas could draw down as much as $100 billion in federal funds over 10 years. In addition, this expansion is estimated to generate more than 300,000 Texas jobs annually over 10 years. According to a well-respected economist, Texas would see a return of $1.29 for every $1 spent on Medicaid expansion, which means it more than pays for itself.
Republican governors and state legislatures across the country are making this work for their states. If Arkansas and Arizona can do it, Texas can, too.
The expansion of Medicaid costs less in four years than what Texas hospitals spend on the uninsured population in one year. Currently, hospitals absorb more than $5 billion per year in uncompensated care, a loss that is passed on to you in the form of higher health care costs and direct taxes in areas that have hospital districts.
The needs of these uninsured individuals will not disappear if Texas fails to close this coverage gap, but the state will continue to lose out on a nine-to-one match and pass the cost down to local hospitals and taxpayers.
I hope I can count on your assistance to inform your family and friends about these new health insurance options and the importance of expanding coverage in our state.
Fighting to improve Texan’s health care
Texas’ legislative session is now well underway, and I have already filed a number of bills to help improve Texan’s access to quality, affordable health care.
Closing the coverage gap is an incredibly important issue, so I’ve filed SB 89, which would extend Medicaid coverage to all those eligible under the ACA. As I discussed above, this bill would provide coverage options to an estimated one million adult Texans.
In addition, I have also filed SB 90 to require insurance companies to get approval from the Texas Department of Insurance before they are allowed to increase their rates. Having to justify rate increases will help ensure that rates are fair for consumers and that your money is truly being spent on care and not administrative costs or bonuses.
Lastly, I’ve filed SB 194 to require health care providers that take samples of a person’s blood for routine medical purposes to submit the blood for an HIV diagnostic test unless the person opts out. According to the U.S. Centers for Disease Control and Prevention (CDC), one of the most effective measures for preventing the spread of HIV/AIDS is routine testing to determine whether individuals carry the HIV virus. Nationally, more than 20 percent of people living with HIV are unaware of it. This epidemic infects around 4,300 Texans each year, but the CDC estimates the number of new cases of HIV could be decreased by up to 30 percent with routine screening in all health settings. It is time we take steps to offer all individuals, regardless of known risk, an opportunity to know their status and stay protected.
I hope you have found this information helpful. Please contact my office should you have any questions or need additional information.
I authored the bill that created Texas’ sales tax holiday in 1999. Since then, Texans have saved over $862 million on essential back-to-school items like clothing, shoes, backpacks, and school supplies. But it’s time to bring the sales tax holiday into the 21st century.
Earlier this week, I held a press conference with Rep. Dwayne Bohac (R-Houston) to discuss companion bills we filed to do to just that: SB 426 and HB 1087. You can watch the press conference by clicking here.
As long as tax cuts remain on the agenda this session, I intend to fight for tax cuts that will go straight to families’ pockets. After all, the sales tax holiday means real tax relief for those who need it most.
Scenes from session
With civil rights leader Julian Bond and a great group of interns at the LBJ School of Public Affairs
I joined other Houston-area leaders to help honor Marvin Rich’s amazing legacy of service with the Anti-Defamation League