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At this point, both bills provide major<br /> benefits to Texans from every walk of life, and millions of uninsured Texans<br /> would gain coverage.</p> <p>In this fact sheet, CPPP provides rough estimates of the scale of impact and benefits for<br /> Texans from health reform coverage expansion proposals. Because the House bill<br /> is more clearly defined at this time, most examples below are from that bill.<br /> We will update this fact sheet to reflect House and Senate developments.</p> <p>Overall, the U.S. Census estimates that 5.9 million Texans were uninsured in 2007. To be conservative, our estimates here include only (1) uninsured Texans and (2) the 4.44 million<br /> of these who are U.S. Citizens (Health reform bills will not cover undocumented<br /> immigrants, and may not cover all legal immigrants.).</p> <p><span id="more-217"></span><br /> • The Congressional Budget office estimates that the House reform bill would result in 95<br /> percent of uninsured Americans gaining coverage. Per these CBO estimates, 4.2 million<br /> uninsured U.S. citizens in Texas would gain health insurance coverage.</p> <p>Affordable Insurance Coverage at Every Income Level Middle‐class Texans who have coverage<br /> today face rising out‐of‐pocket costs and shrinking benefits every year.</p> <p>• Under the reform bills, every Texan will have new security because you cannot lose, be<br /> denied, or be priced out of coverage no matter your age or health status or employment<br /> status. You will no longer have to worry about changing jobs or being self‐employed,<br /> because you will be able to get affordable coverage no matter where you work.</p> <p>• Both bills include annual caps on out-of-pocket costs as part of the minimum<br /> benefit package for health reform. The House caps out‐of‐pocket costs at $5,000<br /> for an individual or $10,000 for a family (at any income level), and the Senate HELP<br /> Committee caps out‐of‐pocket costs at $5,800 for an individual or $11,600 for a family.<br /> The bills also prohibit annual and lifetime benefit limits to coverage. By capping the<br /> amount owed out‐of‐pocket and removing benefit limits, these bills provide critical<br /> financial protection that families do not have today, and which would eliminate<br /> most health‐care‐cost‐related bankruptcies.</p> <p>• About 650,000 uninsured Texans with incomes above 400 percent of (four times)<br /> the federal poverty income level could gain coverage under the House reform bill.1<br /> (income exceeding $88,000 a year for a family of four)</p> <p><strong>Low‐to‐moderate‐income Texans will have all the protections above, plus: </strong><br /> August 18, 2009<br /> Center for Public Policy Priorities/Texas Voice for Health Reform<br /> | 900 Lydia Street | Austin, TX 78702 www.texasvoiceforhealthreform.org 2</p> <p>• Help buying high‐quality health insurance at sliding‐scale prices, with a guarantee that<br /> premiums won’t take more than a predictable percentage of family income. In the House bill,<br /> family premiums costs are capped on a sliding scale, from 3 percent of income for families just<br /> above the poverty level (about $29,300 for a family of four) to 12 percent of income for<br /> families up to four times the poverty level (about $88,000 for a family of four).</p> <p>• Both bills also set sliding‐scale caps on out‐of‐pocket costs for low and moderate income<br /> individuals and families who get subsidies to purchase insurance through the health<br /> insurance exchange.</p> <p>• About 2.3 million uninsured Texans with incomes from 125‐400 percent of the federal<br /> poverty income level (from about $27,600 to $88,000 for a family of four) would qualify for<br /> sliding‐scale help with premiums and out‐of‐pocket costs.2</p> <p>• If Sliding‐Scale help limited to 300% FPL: Some members of Congress advocate<br /> limiting help with premiums and out of pocket costs to Texans under 300 percent of<br /> poverty, rather than 400% FPL. This would make about 3 million fewer Texans (those <br /> with average incomes from about $66,000 to $88,000 for a family of four) ineligible <br /> for sliding‐scale help with health care costs. Of these, 2.8 million are U.S. citizens <br /> and about 385,000 are currently uninsured.</p> <p>• Sliding‐scale help with premiums and out of pocket costs will be available not just for <br /> the uninsured, but also for low‐ and moderate‐income Texans with coverage today who <br /> struggle to pay premiums. For example, in the House bill, premium and cost‐sharing <br /> credits are available to individuals with employer‐sponsored coverage if their share of <br /> premium costs exceed 12 percent of their income. An estimated total of 4.9 to 5.5 <br /> million Texans, includes both insured and uninsured today will be potentially eligible <br /> for sliding‐scale help, though the number who actually need help and choose to use <br /> it will be smaller.3</p> <p>The poorest Texans without insurance will benefit from a major extension of Medicaid to<br /> adults. In Texas today, most of the parents whose kids get Medicaid do not qualify,<br /> and poor adults without children do not qualify at all. Only adults who are seniors,<br /> fully disabled, pregnant women, and a small handful of parents with almost no income<br /> can get Medicaid today.</p> <p>• Under the House reform bill, most parents whose children qualify for Medicaid<br /> could also enroll in Medicaid, as will adults without children at that same income level.</p> <p>• Many states already cover the parents in Medicaid, but Texas and a number of other<br /> states chose to exclude them.</p> <p>• About 1 million uninsured Texas adults under 125 percent of the federal poverty<br /> income level (under $27,600 for a family of four) would qualify for Medicaid coverage.4</p> <p>Thus, the largest group of Texans gaining new coverage under health reform as currently<br /> proposed will be low‐to‐moderate income working families—precisely the folks struggling<br /> hardest to afford care today. A smaller group of working poor adults currently excluded<br /> by Texas Medicaid will gain coverage, and higher‐income uninsured Texans will gain access<br /> to fairly‐priced, decent coverage that cannot be denied or taken away.</p> <p><strong>Economic Benefits to Texas from Increased Health Coverage </strong><br /> August 18, 2009<br /> Center for Public Policy Priorities/Texas Voice for Health Reform<br /> | 900 Lydia Street | Austin, TX 78702 www.texasvoiceforhealthreform.org 3</p> <p>The House has not finalized provisions for how increased Medicaid coverage of poor parents and<br /> adults will be financed; the filed bill would have the cost borne entirely by the federal government ,<br /> while one House committee amendment would require states begin in the third year to pick up 10<br /> percent of the cost of covering the new adults (i.e., federal government would pay 90 percent<br /> thereafter).</p> <p>• Because of Texas’ high uninsured rate and low‐income cut‐off for adult Medicaid coverage,<br /> Texas stands to gain more in coverage from the new “floor” for covering adults than any other<br /> state.</p> <p>• At the same time, the stakes for Texas state government are likewise highest among the<br /> states as Congress decides whether the expanded Medicaid coverage for adults will be fully<br /> federally funded, or whether states will share a portion of the cost.</p> <p>• To illustrate, the average monthly cost per Texas Medicaid adult (who is not disabled, aged, or<br /> pregnant) today is about $305.5 Thus, federally funded coverage of 1 million additional adults<br /> would bring about $3.66 billion additional federal dollars into the state in one year.</p> <p>o This direct influx of federal funds could reverse Texas’ long‐held “donor state” status;<br /> so that Texas taxpayers would get back in federal services as much or more than they<br /> send to the U.S. Treasury in taxes.</p> <p>o According to Texas Economist Ray Perryman, this health spending has a short‐term<br /> multiplier of 3.25, meaning that the new $3.66 billion in health care spending would<br /> generate a total of $11.9 billion in economic activity in the near term, as those health<br /> care dollars are spent in local economies.</p> <p>• If the House Energy and Commerce Committee’s proposal is adopted to have the states<br /> eventually assume 10 percent of the cost of new adult Medicaid coverage, in year 3 after<br /> implementation the federal funding influx for covering 1 million new adults would drop to<br /> $3.3 billion, yielding $10.7 billion in total near‐term economic benefits. With the state picking<br /> up $366 million (10 percent), the net benefit to the Texas economy would still be $10.3 billion<br /> per year.</p> <p><strong>Small Business Impact </strong></p> <p>Health reform bills specifically address the needs of small employers, who face many challenges<br /> finding high‐quality, affordable health coverage. Only 30 percent of Texas businesses with fewer than<br /> 25 employees offer coverage today.</p> <p>• Small businesses will be able to buy health insurance through an “exchange”—a marketplace<br /> where employers can easily compare a variety of health insurance options, including a public<br /> option and non‐profit insurance options, and get clear information on price, quality, and<br /> benefits.</p> <p>• Reform bills include generous tax credits to help small businesses afford coverage. Under the<br /> House bill, businesses with fewer than 25 employees—over 300,000 employers in Texas or 67<br /> percent of all private businesses in Texas6—could qualify for tax credits if they pay average<br /> wages of under $40,000 a year.</p> <p>August 18, 2009<br /> Center for Public Policy Priorities/Texas Voice for Health Reform<br /> | 900 Lydia Street | Austin, TX 78702 <a href="http://www.texasvoiceforhealthreform.org" target="_blank">www.texasvoiceforhealthreform.org</a> 4</p> <p>• An estimated 82.5 percent of Texas employers have annual payrolls under $500,000 a year, 7<br /> and under the House reform bill would be exempt from a requirement to provide coverage or<br /> pay an assessment if they do not.</p> <p><strong>House Energy & Commerce Committee Estimates:</strong></p> <p>The House Committee on Energy and Commerce has released projections of selected impacts of the<br /> Tri‐Committee health reform bill HR 3200, by Congressional District. Texas totals are provided below,<br /> and the full set of E&C estimates can be accessed at<br /> <a href="http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1717&catid=1 56&Itemid=55" target="_blank">http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1717&catid=1<br /> 56&Itemid=55</a>.</p> <p>• 206,600 Texas seniors would avoid the “donut hole” in the Medicare Part D prescription<br /> medication coverage;</p> <p>• 18,050 Texas families would avoid bankruptcy due to unaffordable health care costs;</p> <p>• $4.95 billion in payments to health care providers for what would otherwise have been<br /> uncompensated care each year.</p> <p>__________</p> <p>1<br /> 2008 U.S. Census Current Population Survey, Uninsured U.S. citizens all ages and above 400% FPL.<br /> 2<br /> 2008 U.S. Census Current Population Survey, Uninsured U.S. citizens all ages from 125% to 400% FPL. House reform bill<br /> currently would make all US citizens adults below 133% FPL eligible for Medicaid; 125% of FPL is used here as a proxy<br /> measure because it is a standard income category used in public‐access CPS files.<br /> 3<br /> HealthReform.gov, How Health Reform will Benefit Texas. Estimates using 2007 and 2008 U.S. Census Current<br /> Population Survey.<br /> 4<br /> 2008 U.S. Census Current Population Survey, Uninsured U.S. citizens 19‐64 with income below 125% FPL.<br /> 5<br /> Texas Health and Human Services Commission, Legislative Appropriations Request for 2010‐2011.<br /> 6<br /> Agency for Healthcare Research and Quality, 2008 Medical Expenditure Panel Survey‐Insurance Component.<br /> 7<br /> Estimate from August 2009 Texas Workforce Commission data on Texas employers contributing to Unemployment<br /> Insurance with payrolls under $500,000 per year.</p> <div class="clearer"> </div> <div class="post-meta"> This entry was posted on Saturday, August 22nd, 2009 at 02:42 and is filed under <a href="http://texastortillafactory.com/blog/?cat=10" title="View all posts in Texas" rel="category">Texas</a>. You can follow any responses to this entry through the <a href='http://texastortillafactory.com/blog/?feed=rss2&p=217'>RSS 2.0</a> feed. 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