Author: Thomas

Texas’s Uninsured Will Be a Big Deal

Texas’s Uninsured Will Be a Big Deal

Opinion: Kevin de León’s defenders emerge, but they’re still a minority

On the final day of the year, the Texas legislature will go to polls to vote on whether to pass legislation to raise the price of medical care for the state’s poorest citizens. The bill — House Bill 2 — raises the state’s uninsured rate to 16.5 percent, an increase of more than 20 percentage points over the current uninsured rate of 7.7 percent — and makes the state’s Medicaid expansion optional, like in most other states.

The bill will be closely watched by those who oppose it, and perhaps more concerning to the state’s uninsured, the state’s poorest, is the bill’s requirement that some people must have insurance.

The requirement is that Texans have at least one primary insurance plan, called the Association for Community Affiliated Plans (ACAP), or buy commercial or Medicare Advantage plans. Some critics say the bill will put in jeopardy the individual doctor-patient relationship, and that insurance doesn’t solve the whole problem. Others say the provision is well designed to drive down cost. Either way, the effect on cost would be minimal — about $90 million in 2017, according to the nonpartisan Legislative Analyst’s Office.

Regardless, advocates say the legislation is a step in the right direction. “I think it’s the right thing to do,” said Rep. Kevin de la Huerta, who as a member of House Ways and Means Committee on Health Care, led the development of the legislation. “We have to do everything we can to control costs. And this is an effective way to do it with just a small number of people.”

The most important question for advocates is whether the price-fixing aspect of this bill, which will require Texas hospitals to agree to accept Medicaid patients at discounted prices, will be an effective tool to achieve the state’s aim: to bring down the uninsured rate.

The issue

The uninsured rate in Texas has been steadily falling since 1994, largely due to changes in federal Medicaid expansion. But in the last 20 years, that decline

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