Health Care

Insuring the Uninsured and Medicaid Reform

Governor Rick Perry has proposed tackling two gigantic health care
issues facing Texas today – insuring the state’s uninsured and Medicaid
reform. Of the five and a half million uninsured Texans, two million
are adults with incomes below 200 percent of the federal poverty level.
Governor Perry has proposed a plan called “Healthier Texas” that will
open the door to more affordable insurance options for two million
Texans.

Governor Perry’s “Healthier Texas” plan would create a $250 million
annual fund for a statewide premium assistance program for the
uninsured. The fund would be created with some of the proceeds from the
sale of the Texas lottery and would help uninsured working Texans by
providing premium subsidies for purchasing private coverage or
employer-based coverage. Under this plan, the federal government would
provide an additional $375 million for the program through the Medicaid
disproportionate share hospital program (DSH), for a total of $625
million in all funds. An estimated 2 million uninsured Texans would be
eligible for health insurance under this program.

• Premium assistance will be paid directly to employers, or
  assistance will be provided to individuals wishing to purchase
  insurance on their own without an employer contribution.
• Plans receiving premiums from this program will be certified by the Texas Department of Insurance.
• Premium
  share may not be required of all low-income participants, but will be
  assessed on a sliding scale based on income and needs.
• All
  participants will be required to pay minimal deductibles and
  co-payments. These deductibles will be paid at the time of accessing
  services, with reduced deductibles for routine care, such as an annual
  physical.
• The state can provide funds to be used in Health
  Savings Accounts (HSA) for low-income participants, if they choose.
  Deductibles may be paid from the HSA when participants use services.
• Unused funds will be distributed directly to hospitals to reimburse for uncompensated care, based on need.

Governor Perry also recommends pursuing federal waivers to reform
state Medicaid and CHIP programs. As the cost of managing these
programs continues to grow, the state must develop new approaches to
sustain the programs that serve more than 3 million vulnerable,
disabled and elderly Texans. The governor proposes that we:

• Provide customized benefit packages for specific populations.
  For example, healthy pregnant women have different health care needs,
  and therefore need a different coverage package, than elderly patients
  who require long-term care.
• Provide premium assistance for enrollment in private insurance and employer-sponsored plans.
• Promote consumer choice through health savings accounts and consumer directed services.

Governor Perry recognizes preventative health care is a better
solution than relying on costly emergency room care that too often is
too late for certain medical conditions. By offering private health
insurance to two million working poor Texans at a reduced cost we
empower Texans to provide for the health care needs of themselves and
their families.