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Members of Texas Well & Healthy, an intiative of the statewide Cover Texas Now coaliton

As Texas lawmakers on the House Committee on Public Health and the House Committee on Insurance meet to discuss state implementation of the federal Affordable Care Act (ACA) today, a broad coalition of organizations working to implement the legislation are touting several provisions already in effect that are helping Texans gain access to affordable coverage and updating members on the additional benefits health reform will bring in 2014.

"Over six million Texans have been helped by the prevention coverage improvements in the Affordable Care Act, so there's no question health care reform is working in Texas," said Matt Glazer, Executive Director of Progress Texas.

Committee members have been charged with monitoring implementation of the federal Patient Protection and Affordable Care Act during the interim session. The joint hearing between the House Public Health and Insurance committees will be taking both invited and public testimony about the progress Texas has already made to implement some of the most popular provisions in the new law as well as the work that still needs to be done so that Texans can benefit from the additional provisions coming in 2014. Thousands of Texans across the state signed a petition in advance of the hearing, signaling their support for the Affordable Care Act. Families, business owners and other individuals affected by the law prepared testimony about the benefits of the ACA.

"Many states are creating health exchanges to deliver better value for consumers, and Texas should follow their lead," said TexPIRG Advocate Melissa Cubria, a member of the coalition.

Health exchanges are competitive marketplaces that can empower individuals and small businesses with better, more affordable options for coverage.  Under the federal health reform law, each state has the opportunity to create a state exchange that meets the unique needs of the state's health care system. The exchange must be up and running in 2014. Texas lawmakers failed to pass legislation during the 82nd Legislative session and as a result, the state risks losing federal planning grants as well as the critical opportunity to design a Texas exchange.

According to Laura Guerra-Cardus, associate director of Children's Defense Fund, "The ACA's new competitive health insurance exchange will allow parents to cover even more of our kids through a private marketplace that's easier to use, offers coverage for the care kids actually need, and options parents and small businesses can afford. But that promise of better, more affordable care for Texas children only happens if Texas makes the right choices in implementing the ACA."

"The ACA is already delivering wins for our kids by blocking insurance companies from denying them coverage, helping 2.5 million young adults get the care they need through their parent's health plan and providing tax credits that are already making it easier for small businesses to cover families,"  Guerra-Cardus added.

ACA provisions already in effect and helping Texans right now:

  • The Pre-existing Condition Insurance Plan provides quality coverage for people with pre-existing conditions who have been uninsured for six months or longer. To date, over 4,000 Texans access coverage through the Federally funded program.
  • Young adults can stay on their parent's policy until their 26th birthday, already covering 2.5 million Americans 19-25.
  • More than 120 of Texas' largest employers—e.g., AT&T, American Airlines, Southwest Airlines, and Texas Instruments—have received over $425 million in federal support to cut make early retiree health coverage affordable.
  • Insurers cannot deny coverage to a child based on the child's pre-existing condition.
  • The Consumer Health Assistance Program (CHAP) at the Texas Department of Insurance has helped thousands of Texans looking for health coverage or needing help with health plan denials.
  • Small Employer tax credits of up to 35 percent of a small employer's cost of coverage are available.
  • Year-to-year health premium hikes now are subject to state and federal review to make sure they are reasonable.
  • Health Plans must spend 80 to 85 cents of every premium dollar on health care. Employers and individuals will get rebates estimated at as much as $160 million starting in summer of 2012.
  • Over 1.4 million Texans in Medicare got a check-up or preventive services with no deductible or co-pay.
  • Over 103,000 Texans in Medicare got discounts worth $58.6 million on brand-name drugs in the Medicare Part D coverage gap (the "donut hole") from January to August 2011, an average savings of $565 per person.
  • Medicare Advantage and Part D drug plans' prices dropped for the second year in a row.

What Texans Can Expect from Health Reform in 2014:

  • Large-scale coverage solutions under the ACA are set to launch in January 2014:
  • Uninsured Texans with incomes up to 4 times the poverty level ($88,400 for family of four) will be able to buy private insurance through a new health insurance exchange, with sliding-scale help for premiums and out-of-pocket costs and no state budget dollars required.
  • Insurers will not be able to deny coverage to any individual or small business—nor charge them more based on health history, pre-existing conditions, group size, or kind of work they do. Small employers with 50 or fewer full-time workers will not have to provide coverage, and will not be subject to any penalties.
  • Medicaid will cover U.S.-citizen adults up to 133 percent of the federal poverty level ($29,726/year for a family of four). Parents of kids on Texas Medicaid and other poor adults will qualify for coverage for the first time in 2014.

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