Business & Finance Finance

Why Health Insurance For Texas Should Embrace Reform

Ever since Gallup and Healthways began watching the number of uninsured people in Texas back in 2008, Texas has lagged behind other states. By 2010, nearly 6.3 million Texans (thats 26.8 percent of state residents) lacked health insurance. By the first half of 2011, the situation had become even worse.

You may have heard Texas Governor Rick Perry describing how his state has created 37 percent of the country's new jobs since 2009, but have you heard him explain how Texans are paying for health care? People are known to dial 911 in emergencies. Ambulances still send paramedics and emergency rooms still treat people in critical condition. That's the most expensive form of health care, yet it's also the last resort for people who don't have health insurance.

Would you be surprised if hospitals raised rates for services when they had a lot of unpaid accounts? Would you be surprised if insurance companies raised premiums when hospital charges got more expensive? Ambulances, emergency medical technicians and E.R. staff cost money and it's unrealistic to think that unpaid charges are always written off as charity.

Texas Health Insurance Coverage Is Not Covered By Many Jobs

Part of the problem is that Texas has a high number of retail and service jobs, which are typically the industries least likely to cover employees with health care benefits. Texas can have a low unemployment rate, and still have too many working people who can't afford Texas health insurance coverage.

According to a survey by the Kaiser Family Foundation, 71 percent of the uninsured in Texas are members of families that include someone who is working a full-time job. Almost 63 percent of uninsured Texans have a job that doesn't provide health insurance. Texas officials tend to stick with the federally-mandated minimums for Medicaid so Texans are less likely to get help with health care through Medicaid in Texas than in certain other states.

Change Comes To Texas Health Insurance

When it comes to regulating TX health insurance rates, you won't find a lot of state government enthusiasm, either. However, federal action has made a significant change in health insurance for Texas. You won't see it in any plan you may have purchased prior to health care reform, but the plans that are now available have an important difference from older coverage. Even the least expensive Texas health insurance plans no longer require policyholders to pay for all of their own health care until the plan's deductible has been met.

The U.S. Preventive Task Force looked at examples of health care that were seen to prevent the need for serious, and costly, forms of medical intervention. By requiring Texas health insurance plans to pay for more health care that could prevent disease, federal policy makers have backed away from relying heavily on late interventions that can't always save patients and invested more in upfront treatments that can help patients and keep medical costs low.

Who will benefit from this expanded coverage in Texas health insurance policies? People who could only afford plans with the highest deductibles can now get recommended health care without having to come up with cash for co-pay or co-insurance charges or having to spend enough to meet the plan's deductible. Health care providers should see a decrease in the need for emergency care as preventive health care reduces the need for last ditch efforts. That means fewer big bills for E.R. services, but it also means fewer unpaid claims since people who couldn't afford to see a doctor and waited until they had to go to the E.R. are unlikely to be able to pay off E.R. bills.

Insurance companies will most likely be paying for more health care now that their members can see a doctor with no out-of-pocket costs. If providers end the vicious cycle of raising rates to cover a growing number of unpaid bills, insurance companies, like the rest of us, will end up paying less for health care services. While it does seem to make economic sense, that's not the only reason to ensure that people can get needed health care. Some still believe that human life has value. Maybe protecting that life and protecting the very idea that human life is worth it makes sense in a way that goes beyond economics.
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