Texas health care: Three key challenges

By Higginbotham on August 20 , 2014


They say everything is bigger in Texas. That might be fine if we’re talking about cattle ranches and barbecues, but when we’re talking about the problem of getting everyone covered with health insurance, bigger is definitely not better. Here’s a summary of three key health care challenges that we continue to face in Texas.

The Private Enrollee Challenge: According to a recent study by the Kaiser Family Foundation (KFF), 57 percent of private plan enrollees nationwide were uninsured before the Affordable Care Act (ACA) went into effect. And Texas has the most uninsured, both before the ACA and in future projections. In fact, out of the 44 states ranked, Texas comes in at number 44.

As the study points out, 26.805 percent of private health plan enrollees in Texas had no health insurance prior to the ACA, and 24.81 percent are projected to still be uninsured now that the ACA has been implemented. That’s a 1.99 percent drop; so it’s a slight improvement. But state officials are still wrestling with how to get more individuals covered.

The Medicaid Challenge: Part of the dilemma is that Texas rejected the Medicaid expansion in the new health care law. The law was designed under the assumption that all states would expand Medicaid. So those eligible for Medicaid were excluded from being eligible for the subsidies designed to help low income residents buy insurance.

According to Katrina Daniel of the Texas Department of Insurance, about 6.5 million Texas residents don’t have health insurance, although many can afford it but have chosen not to buy it right now. About 1.3 million uninsured Texans earn less than the federal poverty level, putting them in the "coverage gap." And caring for those and other uninsured residents is costing counties billions of dollars every year.

Social services advocates, local officials and others are putting the pressure on state lawmakers to come up with a "Texas solution" to expand health insurance coverage to the uninsured without accepting the Medicaid expansion, and find a compromise that will give the state more flexibility to spend money available from the federal government to cover more uninsured residents.

The Immigration Status Challenge: Perhaps as much as any state on our southern border, Texas is on the front lines of the immigration issue. Within the past week, The Federal Health Insurance Marketplace has started sending notices to consumers who have a citizenship or immigration data matching issue and have not responded to previous notices via mail, email and phone. The Centers for Medicare and Medicaid Services is sending the notices to 310,000 ACA enrollees, advising them that they have until September 5 to provide additional documentation verifying they are U.S. citizens or legal residents, or their health insurance plans will be rescinded effective September 30. Texas has the second highest number of people receiving the notices, with 52,700 people affected.

Your Texas Health Care Partner

If you need help navigating the complexities of the new health care law, talk to the experts at Higginbotham. We know insurance, and we know Texas. We’ll help you find a health insurance plan that fits your needs – one that doesn’t take a Texas-sized bite out of your budget.

Tags: Individual Life & Health