Wednesday , March 22 2017
Home | Tag Archives: obamacare

Tag Archives: obamacare

Hurd Statement on Healthcare Bill: ‘Insurance is not Healthcare’

In advance of Thursday’s vote overhauling the Affordable Care Act, U.S. Representative Will Hurd released the following statement:

“We must remember, that regardless of its goals, Obamacare has not made healthcare more accessible or more affordable. It has led to expensive and confusing insurance coverage for American families while adding regulations at the expense of small businesses. I see this first hand as I travel the district and hear stories of premiums doubling overnight and outrageous deductibles forcing families to spend their entire savings just to get the care they need.

“And what keeps getting lost in media coverage is this: insurance is not healthcare.  Seven years after the Affordable Care Act was signed into law, there are still millions of Texans who cannot access or afford quality healthcare. ‘Rates of the insured’ are irrelevant if these same people cannot afford to receive treatment.

“Obamacare is collapsing, so maintaining the status quo is not an option. While crisscrossing my district all year and driving 1,600 miles across the country last week, I’ve heard loud-and-clear that while the  American Health Care Act (AHCA) will increase insurance options and competition, it must help those who were previously uninsurable, and strengthen protections for the aged and disabled on Medicaid.

“This is why I’ve been encouraging Leadership in the House of Representatives to make changes to the AHCA prior to our vote on Thursday. Congress needs to provide states the flexibility to address their most pressing issues. I’ve asked for Medicaid expansion and non-expansion states to be treated equally, and I’ve asked that doctors who take care of these vulnerable populations receive the support they need so that they do not opt-out of treating Medicaid patients all together, further restricting access to care.

“Even after Obamacare is repealed, work still needs to be done like extending and expanding programs like the 1115 Waiver. This is a tool used by States to expand Medicaid access for children, families, and those in rural areas.

“I’ve also told House Leadership I will continue to champion funding for Community Health Centers and increased reimbursements for rural providers, and I believe that any final plan must integrate these critical components. I look forward to reading the final bill and hope that these provisions, which are extremely important to my constituents, are included.”

***

A former undercover CIA officer, entrepreneur and cybersecurity expert, Will Hurd is the U.S. Representative for the 23rd Congressional District of Texas. In Washington, he serves on the House Permanent Select Committee on Intelligence, as Vice Chair of the Maritime and Border Security Subcommittee on the Committee for Homeland Security, and as the Chairman of the Information Technology Subcommittee on the Oversight and Government Reform Committee.

Report: Texas Rural Health Care Faces Funding Crisis

AUSTIN, Texas – A new report warns that rural hospitals in Texas could be hit hardest under a Congressional plan to repeal and replace the Affordable Care Act.

It found that proposed funding cuts to the Medicaid program, which already is operating at a minimal level in Texas, could force many rural hospitals to close, leaving hundreds of thousands of people without reasonable access to health care.

David Pearson, director of the Texas Organization of Rural and Community Hospitals, which produced the study, said a new round of funding cuts could devastate the state’s already challenged rural health-care system.

“Continual reduction in reimbursements and available financial resources, either at the state or the federal level, have just gotten to the point where a lot of small hospitals are unsustainable,” said Pearson. “They don’t have the local tax support to make up that difference.”

According to the report, the state’s rural health-care system faces declining reimbursement rates along with rising health-care costs, and Texas already has the highest uninsured rate in the United States.

When Texas lawmakers did not expand Medicaid under the ACA, Pearson said, it put dozens of rural hospitals on the critical list.

He said 16 rural hospitals in Texas have closed since 2013, with an increasing number in financial distress. Pearson also explained that a proposed plan to fund Medicaid through block grants would only shift the financial burden of rural health care to those who can least afford it.

“Local governments and/or local tax districts already fund a large share of Medicaid,” he said. “The tax base in a rural area just isn’t large enough to be able to generate the kind of revenue that would be needed to offset that reduction.”

Pearson said when a rural hospital closes, it creates a damaging ripple effect in the local economy. He added that Texas isn’t the only state facing a rural health-care crisis.

“This really is a national crisis,” he warned. “Unfortunately, Texas leads the way as far as the number of closures, but closures across the country in rural areas are really starting to add up.”

The report, which was completed before the Republicans’ current American Health Care Act was released, was sponsored by the nonprofit Episcopal Health Foundation.

Author: Mark Richardson – Texas News Service

Opinion: Hurd on the Hill – Constituent-Driven Policy & Obamacare Opinions

Last week, I hosted my thirteenth live telephone town hall meeting in the last two years.  Although they are no substitute for the 50-plus in-person town halls and more than 400 public events I have also led, telephone town hall meetings have allowed me to communicate with over 630,000 constituents since 2015.

Telephone town halls are just what they sound like – town hall meetings conducted over the telephone. They give me the opportunity to connect with thousands of constituents while I’m in Washington for the legislative session, and are one of many ways that I listen to constituents on a regular basis.

Over the course of 92 minutes last Thursday evening, I spoke with thousands of constituents from across the district and answered their questions live. I also asked a series of poll questions to get important feedback from folks.

Among several topics that were discussed, we spent the majority of our time talking about how Obamacare has failed, and what constituents can expect with its repeal and improved replacement in the future.  In response to my survey questions, I learned that half of over 500 respondents are paying more for insurance today than they were before Obamacare, and more than 40 percent of them have, or know someone who has had, to change insurance plans or doctors since Obamacare was implemented.

According to the U.S. Department of Health and Human Services, Americans receiving insurance through the Obamacare exchanges have been pummeled by a 25 percent average increase in premiums. These numbers are crippling American families and the situation is only going to get worse with fewer coverage options and even higher costs.

I wanted to discuss Obamacare on the telephone town hall because I have spent a lot of time lately reassuring constituents that as we repeal and replace it, individuals and families will not be left without healthcare. After asking another poll question, over 70 percent of respondents agreed that Congress should not repeal Obamacare without a replacement. This tells me that most of us are all on the same page. I am confident that Congress will deliver on our promise to provide a stable transition period to a patient-centered health care system that gives Americans access to quality, affordable care.

It’s also clear that key provisions of our replacement plan, like tax credits and guaranteeing coverage for those with pre-existing conditions, have broad support. Not surprisingly, constituents on the call favored being incentivized by tax credits when purchasing insurance, rather than being fined for declining it. Over 80 percent of respondents also agreed that certain features of Obamacare, such as guaranteed coverage for pre-existing conditions and staying on a parent’s plan until age 26, should stay in place. These are features that House Republicans will preserve.

In upcoming weeks, Congress will begin the process of repealing Obamacare’s most burdensome components – including eliminating the individual and employer mandate penalties – and move forward with patient-centered reforms.

As we move through the process, I assure you that your experiences are important to me and will continue to shape my opinions on how we should move forward. Please continue to reach out to me with your questions and concerns, and, if you would like to participate in future telephone town hall meetings, constituents may subscribe on my website.

A former undercover CIA officer, entrepreneur and cybersecurity expert, Will Hurd is the U.S. Representative for the 23rd Congressional District of Texas. In Washington, he serves on the House Intelligence Committee, as Vice Chair of the Maritime and Border Security Subcommittee on the Committee for Homeland Security, and as the Chairman of the Information Technology Subcommittee on the Oversight and Government Reform Committee.

Opinion: Senator Cornyn – Obamacare Replacement Major Step in Right Direction

WASHINGTON – Tuesday on the Senate floor, U.S. Senator John Cornyn (R-TX) discussed the American Health Care Act. Excerpts of Sen. Cornyn’s remarks are below, and video of his remarks can be found here.

“The fact of the matter is that Obamacare has been one broken promise after another. President Obama and advocates of this law said that if you wanted to keep your plan, you could keep it. But that didn’t pan out.” 

“They said if you liked your doctor, you didn’t have to find another one. That didn’t turn out to be true either. And they promised people across the country would have more coverage, more options, and better health care, all at a more affordable price. Well, that ended up not being true either.”

“Now we have an opportunity to do better for the people we represent, who are counting on us to deliver, to repeal Obamacare and replace it with options that work, and I believe the plan released last night is a major step in the right direction.” 

“Patients need better tools, like health savings accounts…We need to break down the barriers that restrict choice and keep Americans from choosing an insurance plan that works…And we need to empower employers, particularly small business owners, to provide their employees with the kind of affordable coverage that meets their needs.” 

“We need to move health care decisions out of Washington and send them back to the states and back to patients and families and their doctors.” 

“So I’m glad our colleagues in the House and our friends in the White House fully understand why this is such a priority and why we need to keep the promise that we made. As soon as we can do that and deliver on that major promise to the American people, the sooner we do that, a whole lot of American families across the country will feel relief.” 

Senator John Cornyn, a Republican from Texas, is a member of the Senate Finance, Intelligence, and Judiciary Committees

Report: NM Makes Progress on Insuring Children, But Poverty Worsening

SANTE FE, N.M. – Children in New Mexico struggle against endemic poverty, but there are some positive signs, according to the KidsCount 2016 Databook released Tuesday.

The report says 141,000 New Mexico children live in poverty. That is 29 percent of kids statewide, a figure that has gotten worse since 2008. It also shows that, in one-third of families, neither parent has secure, full-time year-round work.

James Jimenez, executive director of New Mexico Voices for Children, which issued the report, says there is some good news: the state has made major progress on insuring more kids. He credits the expansion of Medicaid under the Affordable Care Act.

“That’s really important because when children get an opportunity to have their well-baby checks and so on, there’s a much greater likelihood that they can avoid diseases that will cause them delays as they develop,” he explained.

Jimenez notes, however, that the Medicaid expansion is under serious threat with the upcoming repeal of Obamacare. The research did show one other positive trend, the state has slightly reduced the number of low-birth-weight babies.

The report blames many of the state’s stubborn problems on the lackluster economy, which still hasn’t recovered from the recession despite multiple rounds of tax cuts designed to create more economic activity. Jimenez says the state’s whole approach should be overhauled to prioritize the needs of low-income families.

“We’ve got some other recommendations that would include better ways to fund our state government, so that we really provide the kinds of services that we think are necessary, including funding for child care,” he said.

The authors also recommend lawmakers change the income limits so more people qualify for child-care assistance, raise the minimum wage and protect food-assistance programs from further cuts.

Author: Suzanne Potter, Public News Service

Hurd on the Hill: Paving the Way for Better Healthcare

“What’s the point of having health insurance anymore?”

I’m often asked this question by constituents who are pummeled by out-of-pocket costs under Obamacare.

It’s a great question. And after six years of this experiment, it is clear that Obamacare has failed the American people. Families face skyrocketing premiums and soaring deductibles, making healthcare more unaffordable than ever. In Texas this year alone, we’ve experienced a 34 percent increase in Obamacare premiums, forcing us to pay more each month just to keep our coverage. Couple that with multiplying deductibles in the thousands of dollars, and it’s no surprise that many people feel like they don’t have coverage at all.

Obamacare is collapsing as we speak. Only five of the original 23 health insurance CO-OPs remain in business, and these failures have cost taxpayers more than $1.8 billion.  As insurers continue to drop like dominos, options for healthcare coverage continue to shrink. Currently, over a third of counties nationwide have only one choice for health insurance. That is not a choice – that’s a monopoly.

A modern-day health care model should allow patients—along with their health care providers— to make decisions about their health care needs, instead of a federal administrator. Loving parents working with their local doctor would do a far better job of protecting the health of their children, and caregivers at home know far more about their family’s need than bureaucrats in Washington.

The Good News

The good news is that we are finally on the same page. Eight in ten Americans agree that we need to significantly change or repeal Obamacare altogether, and Congress is responding by repealing Obamacare and paving the way for better healthcare for all Americans.

We already have a replacement plan, and it provides more choices and less top-down mandates. It also makes sure that you never have to worry about being turned away because of pre-existing conditions, age, income, or circumstance. Our plan eliminates unnecessary bureaucracy to accelerate the development of life-saving devices and therapies, and it protects Medicare for today’s seniors, while preserving the program for future generations.

I am fighting with my colleagues to provide relief for millions of struggling families. The end goal is a patient-centered system that lowers costs and provides more choices for the American people.

What to Expect

As we work to replace Obamacare with something better, there will be a stable transition period so that no one has the rug pulled out from underneath them. Patients currently on the healthcare exchange will not lose coverage without a replacement, kids will still be able to stay on their parent’s plans, and patients with preexisting conditions will not be turned away.

Our blueprint lays out a step-by-step process that begins with a budget resolution for fiscal year 2017, authorizing Congress to fast-track repeal legislation with only simple majorities in the House and Senate. This legislation passed last week, paving the way for us to begin in earnest to repeal and replace this job-killing law that has neither made healthcare more affordable nor protected patients. In the coming months, Congress will work to first repeal tax-related provisions, such as the individual mandate that eliminated choice for patients across the country, while maintaining protections for those with pre-existing conditions and strengthening successful programs like Medicare Advantage and Health Savings Accounts.

We are committed to doing this the right way so that every American has access to quality, affordable coverage for years to come. Learn more about our plan at www.abetterway.speaker.gov

Millions of Texans Could Lose Coverage if ACA Repealed

AUSTIN, Texas — Congress has set in motion what it says is a plan to repeal and replace the Affordable Care Act. But what could happen in Texas if the plan is only repealed?

One study projects that ending Obamacare without immediately enacting an equivalent plan would result in 2.6 million Texans losing health coverage by 2019. Anne Dunkelberg, associate director at the Center for Public Policy Priorities, which produced the study, said a repeal of the plan would hit the state’s working families hardest.

“Close to 85 percent of them are getting subsidies. The average subsidy is 75 percent of the premium,” Dunkelberg said. “So, if those subsidies go away, the vast majority would not be able to afford to just pick up the other 75 percent of the premium.”

The study also found that Texas stands to lose about $62 billion in federal healthcare funding over the next decade if the ACA is repealed, and it would pay out billions more to doctors and hospitals to cover the cost of uncompensated care.

Congress has vowed to replace Obamacare but has yet to reveal the details of any plan it is considering.

Dunkelberg said that if Congress only repeals the plan, the significant gains made in the state’s uninsured rate by Obamacare would likely be reversed.

“Even though Texas still has the worst uninsured rate, and the highest uninsured number in the country, and didn’t do the Medicaid expansion along with 18 other states, we still had a big, major reduction in our uninsured rate as a result of it,” Dunkelberg said.

She said she’s also concerned that any new plan could reverse basic requirements, allowing insurers to sell policies that don’t cover key expenses such as prescription drugs, mental health or maternity care.

“Being able to have a talking point that says that the price of the premium went down when in fact the reason it went down is that it’s no longer covering anything that you actually need, and it leaves you open to medical bankruptcy,” Dunkelberg said.

The report warned that a repeal of the ACA without an adequate replacement would mean that almost 30 million Americans could lose access to affordable health care.

Author – Mark Richardson, Public News Service

Analysis: Repeal of Healthcare Law Likely to Cause Chaos

CHARLESTON, W.Va. — Repeal of the Affordable Care Act without immediate replacement would throw the U.S. healthcare system into turmoil for the next three years, according to economists.

The Urban Institute projected that the most likely plan for repeal would leave nearly 30 million Americans uninsured by 2019, send insurance markets into chaos and threaten the economic viability of hospitals around the country.

Edwin Park, vice president for health policy at the Center on Budget and Policy Priorities, predicts insurers will start canceling coverage in the face of billions of dollars in losses if there is no longer a mandate for consumers to buy insurance. But, Park said, the largest impacts may come in two years, when the repeal of the Medicaid expansion and the insurance subsidies that help people pay for coverage will likely kick in.

“More than doubling the number of uninsured that otherwise would occur,” Park said. “And that would be a higher number than was in place pre-Affordable Care Act, because of the virtual collapse of the individual market that would result.”

President-elect Trump and Republicans in Congress have criticized Obamacare for its rising premiums and reduced choice of doctors and insurance options. They campaigned on the promise of immediate repeal, even though the program has just finished its largest signup period ever.

First up for repeal are the taxes, mostly on high-income households, that pay for much of the program. Park said they found that more than half of these tax cuts would go to the rich – millionaires or richer – according to Congressional Budget Office figures.

Without that revenue, he said replacing the ACA would be difficult, or could require taking funds from Medicare or Medicaid. Park said that could explain the delay.

“The most critical aspect is that there is no replacement plan,” Park said, “that replacement would happen at some subsequent point, assuming there even is a replacement plan.”

The Urban Institute projects that, by 2019, healthcare providers will have to give four times the amount of uncompensated care they do now. Park said in that year, they will also lose $146 billion in revenue because they have fewer patients with insurance – which will be a threat to many hospitals.

“Rural hospitals in states that have seen improvements because of adoption of the Medicaid expansion in their states – that would all be reversed, and more, under ACA repeal,” Park said.

More information is available at cbpp.org

Dan Heyman, Public News Service

Report: ACA Repeal Without Replacement Could Hurt Texans

AUSTIN, Texas – The incoming Trump administration and a Republican Congress are vowing a partial repeal of the Affordable Care Act, but they’re vague about a replacement plan.

A new report from the Urban Institute says a repeal could cost as many as 30 million Americans access to health care, including some 2.6 million people in Texas.

Patrick Bresette, director of the Children’s Defense Fund-Texas, says repealing Obamacare could bring unintended consequences to the health care market and the U.S. economy.

“There should be no way that Congress is allowed to repeal this without a clear plan of what they are going to replace it with, or pulling out certain aspects of it,” he stresses. “We’ve likened it to the game Jenga, where you pull out one block and you think you’ve only dealt with that, but the ripple effects are going to be enormous.”

The study shows that a repeal would increase the number of uninsured Texans to 6.9 million people, keeping the state with the highest uninsured rate in the country.

Texas would also lose $62 billion in federal health care funding over a 10-year period.

Joan Alker, executive director of the Center for Children and Families at Georgetown University, says that under the ACA, 95 percent of American children now have health insurance.

“But now Congress is poised to take a U-turn and taking away affordable coverage options which would actually double the number of uninsured kids,” she states.

Bresette adds that it’s not just the poor who have benefited from Obamacare.

“All of us are paying a little bit less for health insurance than we might,” he points out. “We’ve got protections for pre-existing conditions, elderly people on Medicare benefited from improvements in prescription drug costs. So I think that it’s important to remember that we’ve all benefited one way or another.”

The report says the “repeal through reconciliation” plan could cut financial assistance with premiums, individual and employer mandates and the Medicaid expansion, while keeping some reforms such as a ban on exclusions for pre-existing conditions.

Author: Mark Richardson – Texas News Service

State Sen. Rodríguez, SEIU Texas to host Health Information Fair and Health Care Roundtable

State Senator José Rodríguez and SEIU Texas are co-hosting a health information fair and roundtable discussion on how to ensure health care access in El Paso in 2017 and beyond on Thursday, December 8.

The outcome of the presidential election raises new and significant uncertainties about national health care policy priorities. Ensuring access to affordable, quality health care is a top priority for El Paso’s delegation in the 2017 State Legislative Session.

This roundtable discussion will give El Pasoans a chance to learn more about the decisions facing health care advocates and leaders who are working to expand access to health care for all El Pasoans.

As a result of the Affordable Care Act, or Obamacare, more than 20 million Americans have gained health care coverage. If Obamacare is repealed, most if not all of these Americans stand to lose vital access to health care. In Texas, Obamacare has dropped our uninsured rate from 25 percent to 17 percent, but we still have the highest number (4.6 million) and percentage of uninsured residents of any state in the country.

In addition to insurance coverage, Texas has benefited from a federal waiver program that has brought $29 billion to support our health care safety net over the past five years. This waiver program is at a critical juncture. The Obama administration gave Texas an extension until December 2017, but it’s now uncertain what may happen next.

As we head into the next legislative session, we wanted to provide an opportunity for El Pasoans to discuss and learn about the pressing issues we’ll be facing both at the state and federal levels, said Rodríguez.

As hospital workers on the front lines of patient care, we’re committed to making sure all El Pasoans have access to high quality care that is affordable,” said Rosa Martinez, a Certified Nursing Assistant at University Medical Center of El Paso and a member of SEIU Texas. SEIU members are proud to be advocating for solutions that ensure that all El Pasoans have access to high quality care.”

The Roundtable Discussion will include State Sen. José Rodríguez, UMC El Paso CEO Jacob Cintron, and SEIU National Healthcare Leader Kirk Adams. County Judge Veronica Escobar will serve as moderator.

•       What: El Paso Health Information Fair & Roundtable Discussion: Ensuring Health Care Access in 2017 and Beyond

•       When: 4 to 7:30 p.m., Thursday Dec. 8, 2016

–          Health Information Fair from 4 to 6 p.m.

–          Roundtable Discussion from 6 to 7:30 p.m.

•       Where: La Fe Culture and Technology Center, 721 South Ochoa, Rear Building

Study: Texas Insures More Kids But Lags Behind Other States

AUSTIN Texas – Texas cut the number of its uninsured kids by 23 percent between 2013 and 2015, according to a new report by the Georgetown University Center for Children and Families. The report said nationwide, a record 95 percent of all children are now insured. Researchers credit the expansion of Medicaid under the Affordable Care Act for insuring more adults, who then signed up their kids.

But Anne Dunkelberg, associate director of the Center for Public Policy Priorities said because Texas did not expand Medicaid, it still has the highest rate of uninsured children in the country.

“One of the things that research has shown over the last 10 to 15 years in the United State is that any time you cover parents, you get much better enrollment of kids,” she explained. “And, the states like Texas that have not done Medicaid expansion tend to be some of the ones with the worst uninsured rates for kids.”

In Texas, 9.5 percent of children, or about 680,000, lack health insurance, meaning about one in five kids is still not covered. But despite that, according to Dunkelberg, Texas has made significant progress, insuring an additional 206,000 children during the study period.

Joan Alker, executive director at the Georgetown center and co-author of the report, said it is important to have a strong Medicaid program, strong CHIP program, and that the Affordable Care Act remains in place.

“Health coverage is so important for kids,” she said. “It allows them to access primary preventive care, they’re more likely to attend school, graduate from high school and even go to college.”

Alker said polls show many Americans are not aware of the success of these programs.

“Only 28 percent were aware that the number has actually gone down, added Alker. “So this is a success that we’ve had as a country, it’s not well known and it’s something we can all feel good about.”

She also added that the drop in the number of uninsured children is spread across income, racial and geographic lines.

Author: Mark Richardson, Public News Service (TX)

More Texas Young Adults, Fewer Hispanics Insured Under ACA

HOUSTON – More young adults in Texas have health insurance, according to a new study by Rice University, which also finds that fewer Hispanics and low-income adults have coverage.

The report says the number of young adults in Texas without health insurance has dropped by 35 percent since the Affordable Care Act (ACA) went into effect in 2013.

But the study also shows that a significant number of Texans remain shut out of the health insurance marketplace.

Elena Marks, director of the Episcopal Health Foundation and a co-author of the study, says because Texas has opted to not use federal dollars to expand Medicaid under the ACA, many people are left without options.

“The lowest income groups really don’t have an opportunity to buy coverage,” she points out. “So whether they’re young or old or black or white or purple, there’s just not a lot that the ACA offers other than Medicaid expansion, which the state has turned down.”

Marks says the study found more than one-third of young Hispanics and 56 percent of low-income young adults in Texas still do not have health insurance.

She says that despite having the opportunity to enroll through the ACA, one-third of Hispanics in Texas remain uninsured, compared with just 10 percent of the white population.

Marks says the increase in coverage of 18 to 34-year-olds, often called young invincibles, is due to more companies offering insurance to employees, along with rules that allow children up to age 26 to remain on their parents’ policies.

She says the participation of young adults in the health insurance marketplace is important to its long-term success.

“The young invincibles, despite people saying they’ll never get insured, actually have become increasingly insured,” she points out. “They still lag behind the oldest adults. We’re pleased to see that they have made gains. We’d like to see them make greater gains.”

The report is part of a series tracking the implementation of the Affordable Care Act by Rice’s Baker Institute for Public Policy and the Episcopal Health Foundation.

Author: Mark Richardson – Public News Service

Health Insurers’ Exit Spells Trouble for Obamacare in Texas

The roughly 1.3 million Texans who bought health insurance under the Affordable Care Act will likely have fewer, more expensive coverage options in 2017, as health plans continue to announce they will no longer sell their products in Texas.

Insurance start-up Oscar announced on Tuesday it would pull out of the Texas market, joining veteran health plans Aetna, UnitedHealthcare and Scott and White on the list of companies that recently announced they would abandon the marketplace created by President Obama’s signature health law. The companies said their costs of providing coverage to middle-income Texans have been unsustainable, fueling concerns about a lack of competition and consumer choice within the health insurance market next year.

The announcements come at a time of uncertainty for health insurance markets nationwide, with several major health insurers opting to abandon the exchanges in all but a handful of states. And Cigna, another health insurance company, last week told the Houston Chronicle it was “in discussions” with state regulators about exiting the Texas exchange.

I think what we should be expecting is premiums that are substantially higher, and I think there’s a real risk that other insurers pull out,” said Michael Morrisey, a professor at the Texas A&M University School of Public Health. “We may be beginning to see the death spiral of insurance plans in the exchanges.”

In addition to the shrinking market, major health insurers that have not indicated they will leave the exchange — most notably Blue Cross Blue Shield of Texas — have asked the federal government for permission to raise their monthly costs by up to 60 percent. Blue Cross says its financial losses in the marketplace were unexpectedly large, and last year the company ceased offering one of its plans, which covered 367,000 Texans.

A spokeswoman for Blue Cross Blue Shield of Texas said Tuesday the company had made “no final decisions” about its 2017 offerings.

“We have been in this market for 80 years and, while some carriers have chosen to exit the market, we are working towards continuing to provide health insurance options for Texas consumers,” the spokeswoman, Edna Perez-Vega, said in an email.

“However, that must be done in a sustainable way,” she added, noting that the insurer lost $770 million in the Texas marketplace in 2015.

In addition to Blue Cross, about a dozen smaller insurers are expected to remain in the Texas marketplace in 2017.

Sherri Greenberg, a professor at the University of Texas’ LBJ School of Public Affairs, said monthly health insurance premiums were likely to rise across the state. But she said many Texans might not feel the effect of those increases because they will continue receiving federal subsidies — a pillar of the law meant to offset the cost of health care for many Americans.

Greenberg said 2017 price hikes in the Texas market could vary widely across the state, with rural markets likely to see the biggest changes.

“If you had very few options to begin with, and now you’re left with [even] fewer carriers and reduced competition, that can mean an increase in insurance premiums,” she said.

Competition could still improve if additional insurers choose to enter the Texas marketplace before the Sept. 23 deadline. It is also possible that additional health plans will choose to exit the marketplace before then.

The Obama administration has said it is confident that the “majority” of people signing up for coverage under the Affordable Care Act will have multiple options for coverage in 2017 and will be able to purchase a plan for less than $75 per month. The federal government has reported that the average Affordable Care Act health plan in 2016 cost about $400 per month, but after tax credits, the average enrollee paid $113 per month.

Lack of insurer participation in the Affordable Care Act exchange is of particular concern for rural areas. Scott and White, which says it will continue to offer some individual market plans outside of the exchange, has had a significant presence in some of the state’s more sparsely populated regions.

An Aug. 19 analysis conducted by the health care consulting firm Avalere Health found that more than a quarter of Texas’ 26 federally designated geographic areas could have just one insurance carrier offering plans on the exchange in 2017.

“Lower-than-expected enrollment, a high cost population, and troubled risk mitigation programs have led to decreased plan participation for 2017,” Dan Mendelson, the company’s president, said in a statement.

Health economists say newly insured Texans have required more expensive care than companies were prepared to handle. Insurers last year struggled to enroll enough healthy people to offset the costs of patients with expensive medical needs, despite a provision in the law that requires people without health insurance to pay a fine. Health plans have also criticized Congress for cutting funding to programs that were intended to offset their financial losses on the exchange.

The Affordable Care Act offers subsidies to some middle-income Americans who buy insurance on the exchange, and it requires insurers to provide more comprehensive — and, for insurers, more expensive — coverage. The law has also led to a drop in the percentage of Texans without health insurance, from 25 percent of Texans before the law’s passage to roughly 17 percent in 2016, according to the Obama administration.

Many of the health insurance companies leaving the exchange in 2017 have said they will return in later years if the market becomes less volatile.

Mario Schlosser, the chief executive of Oscar, which insured about 7,000 people in the Dallas-Fort Worth area, said in a statement that uncertainties in the market had made it “challenging for us to operate effectively and continue to deliver access to quality healthcare.”

“We hope to return to these markets as we carry on with our mission to change healthcare in the U.S.,” he wrote.

The enrollment period for 2017 coverage starts Nov. 1.

Read more:

  • Federal officials have specifically targeted Texans in their efforts to boost enrollment in health insurance under the Affordable Care Act.
  • U.S. Census data in 2015 showed that, for the first time in more than a decade, Texas’ uninsured rate dipped below 20 percent. Still, Texas continues to have more uninsured people than any other state.

Disclosure: Blue Cross Blue Shield of Texas, Texas A&M University and the University of Texas at Austin have been financial supporters of The Texas Tribune. A complete list of Tribune donors and sponsors can be viewed here.

Author:  – The Texas Tribune

Report: Numbers drop, but Texas still leads US in uninsured children

More children in Texas and the nation have health coverage, according to a new report from the Georgetown University Center for Children and Families, but Texas leads the nation in the number of kids still without insurance.

The report found the rate of uninsured children nationally dropped to a historic low of six percent in 2014, the year the Affordable Care Act (ACA) went into effect. Anne Dunkelberg with the Center for Public Policy Priorities cites the expansion of Medicaid eligibility for adults under the ACA – a move Texas has yet to make – as a significant factor for the increased coverage of kids.

“Folks usually refer to that as the so-called ‘welcome mat’ effect,” says Dunkelberg. “When you put out the welcome mat and say, ‘We have coverage for everybody,’ then you end up getting whole families enrolled, and that gets more children covered as well.”

The report found that from 2013 to 2014, the uninsured rate for Texas children declined from 12.6 percent to 11 percent, down from an estimated 888,000 uninsured children to just under 784,000. Dunkelberg says with that many kids in Texas still without coverage, there’s clearly more work to do. According to the study, nearly 4.4 million children in the U.S. still don’t have health insurance.

The report also found that after the rollout of the ACA, 25 states recorded declines in the number of uninsured children, and no state showed significant increases.

Study co-author Joan Alker, executive director at Georgetown’s Center for Children and Families, says the study confirms that years of work by policymakers and other stakeholders to reform health care in the U.S. is beginning to pay off.

“The Affordable Care Act, which is a significant domestic policy initiative, was really building on a decade of success for kids with Medicaid and CHIP,” she says, “But we did see a significant decline from 7.1 percent to six percent in the rate of uninsured kids.”

The report also found that Hispanic and school-aged children were disproportionately uninsured, as well as children living in rural areas or low-income families. Alker says if more states decide to expand adult eligibility for Medicaid coverage, uninsured rates for children could drop even further.

Author: Eric Galatas – Texas News Service

Sizzler 728