In the United States, employee health insurance is an important factor for someone looking for a job. With the Affordable Care Act in place, employees who do not have health insurance will have to pay penalties, and this also applies to employers who do not offer coverage for all of their employees. Because of this there has been a huge boost in coverage throughout the country, but the one state that is leading the way is Texas. In a recent study done by the Baker Institute for Public Policy, it has been shown that employee health insurance in Texas has increased exponentially.
In 2013, 67 percent of employees got health coverage in Texas, while now that the Affordable Care Act has passed, 68 percent have access to insurance through their employers. This is a surprise to Texans, since the fear when the ACA passed was that employers would drop health insurance completely, but instead, they have adjusted to the change and made it available for all of their employees. This affects a large majority of people, including low income employees who would not otherwise have access to health insurance in Texas.

It is easy to see the big change the Affordable Care Act has provided for these low income employees. In 2013, only 35.9 percent of them were covered, while now in 2015, up to 40.3 percent have health insurance. This is an increase of 12 percent in just two years! Although not all employers are offering health coverage, the number is growing quickly.

So why is employee health insurance in Texas becoming the choice for all companies? Employers do not want to pay fees because they do not provide affordable health coverage, which is why they lower their rates and increase the amount of people their health insurance covers. By making it more affordable, low income employees are able to obtain the insurance they need while also avoiding the penalty fees they also would accrue for not getting coverage. It is a win-win scenario for both parties and can end up saving the employer quite a bit of money in the long run.

There is still work to be done, however. Not all low income employees receive health coverage in Texas, with the cost being the largest deterrent. Of all uninsured workers in the state, 55 percent of them say it is because they cannot afford to purchase insurance, not even through the Affordable Care Act. For other income brackets, the change has not been as widely noticeable, with the percentage of higher income workers who have health insurance in Texas remaining at 85 percent from 2013 until now.

Making health insurance in Texas affordable for employees is beneficial not only to the employee but to the employer, as well. A company that provides this kind of coverage attracts better workers and ensures that these workers remain with them for longer periods of time. Productivity increases when employees have health insurance, which can offer a boost to the company without requiring more employees.

Health insurance in Texas is is expected to continue to expand to cover more people throughout all of the income bracket.

Recently, the passage of the federal Affordable Health Care Act sparked widespread national debate. Commentators describe aspects of the new legislation which they believe prove beneficial, or damaging. The law remains controversial in the sense that it still arouses vehement discussion from proponents and critics. Texas lies in the crucible of this ideological firestorm.

Texas: A Big State With Massive Insurance Coverage Issues

What makes Texas a focal point for insurance issues? For one thing, the state’s significant size and economic importance mean that it will necessarily generate considerable attention during any insurance discussion. Health insurance in Texas attracts widespread interest from the media today.

And unfortunately, a second factor may place Texas in a bellwether position on this issue, too. Texas possesses a very large number of uninsured. Prior to the passage of the Affordable Care Act, fully 25% of the Lone Star State’s population lacked any health coverage. Health insurance in Texas has reportedly risen since the federal provisions took effect, but significant numbers of uninsured remain.

The situation with respect to automobile insurance coverage also gives cause for dismay in Texas. It is one place where, in large numbers, uninsured drivers impose a huge risk on others. Some 14% of Texas drivers possess no liability insurance. Large numbers lack any insurance at all. Although some insurance companies reportedly sell policies providing coverage for uninsured drivers in the state, many uninsured do not carry the legally required liability insurance.

The Future of Health Insurance in Texas

Some critics of the federal Affordable Care Act note that in some states, such as Nebraska, private health insurance policy premiums have risen, even as more citizens obtain lower cost coverage through federal programs such as Medicaid. In fact, despite cooperatives, high premiums still prevent many Americans from obtaining health insurance. Health insurance in Texas reflects these concerns.

Unless they are willing to sign up for Medicaid, a federal health program for low income people, in large numbers impoverished families cannot afford the premiums required to obtain health insurance in Texas. And insurance continues to take a significant portion of many family incomes. For example, one recent study indicated that the typical Texas household receives $41,284 a year; of this amount, some $5,649 goes towards the payment of insurance premiums, i.e. roughly 13.7% of income.

Following the passage of the Affordable Care Act, Texas accepted generous federal subsidies to pay for uncompensated health care. However, the state declined to expand the Medicaid program for health insurance in Texas. Potentially, low income Texans who do obtain health insurance in Texas face the uncomfortable prospect of enjoying Medicaid coverage without a sufficient number of private physicians willing to accept new Medicaid patients.

An Analogy with Automobile Insurance

Health insurance in Texas for the uninsured may pose some analogies with the lack of automobile insurance. Just as federal regulation of health insurance in Texas seeks to compel families to sign up for low cost health insurance coverage under the threat of paying fines for non-compliance, authorities have endeavored to encourage compliance with laws mandating automobile liability coverage.

In 2009, Texas implemented a creative program called TexasSure. It established a massive database. Every person registering a vehicle expends $1 to support the initiative, which matches vehicle ID and license plate numbers with lists of insured drivers. Some 25,000 letters issue every week directing the uninsured to verify their insurance coverage and warning them of fines in the event of failure to abide by the liability insurance requirement.

Municipal ordinances in Dallas, and more recently, Texarkana, authorize police to have vehicles towed if an owner stopped for a traffic violation or an accident possesses no insurance.

Yet even as health insurance in Texas does not attract universal compliance, neither does automobile liability insurance. Automobile liability coverage costs only $35 to $40 a month in most cases.

Critics of the enforcement programs point out many insurance companies penalize drivers with poor credit scores or those in other “high risk” groups by charging higher premiums. Robert Hunter, who previously served as a Texas Insurance Commissioner, explained: “Legislators and insurance regulators need to recognize that the uninsured motorist problem is much more about affordability than about irresponsibility.”

Health Insurance in Texas: The Future

Health insurance in Texas continues to generate debate. Dianna Wray wrote an article about health insurance in Texas and Houston’s charitable Memorial Hermann facility. She noted that Time reported M.D. Anderson recently made a profit of $531 million. That renowned facility earned criticism for trying to deny services to an acute leukemia patient with limited insurance coverage until she paid an outstanding $100,000 on her bill.

Conclusion

Health insurance in Texas matters to many people. What changes will occur to health insurance in Texas? Only time will tell.

The Affordable Care Act is designed to expand coverage to a large number of low-income individuals seeking health insurance in Texas. Although the expansion of Medicaid was supposed to be adopted nationwide, the Supreme Court ruled in June 2012 that the decision to expand Medicaid to a larger number of low-income citizens was left up to the discretion of each state. Sadly, health insurance in Texas remains unavailable for at least 25 percent of people living in this state.

Several states, including Texas, have opted not to expand Medicaid coverage. This has resulted in many individuals falling into a coverage gap, where their income is too high for them to be eligible for Medicaid but too low to qualify for premium tax credits under the Marketplace. Only a small percentage of people qualify to receive welfare health insurance in Texas which also has a large population of uninsured citizens.

For many living on a limited income, the options for receiving health insurance in Texas depend on where their income falls. If their yearly income reaches above $11,670 as a single person or about $23,850 as a family of four, they will be able to buy a private health insurance plan in the Marketplace and may be eligible for premium tax credits and other savings based on their household’s income and size.

However, if an individual makes a yearly income of $11,670 as a single person or about $23,850 as a family of four, they will not qualify for lower costs for private insurance based on their income. Based on Texas’ existing rules, there is the possibility that a single person or family could still qualify for Medicaid if they apply, even without the expansion. Health insurance in Texas is usually available for someone who has a disability, has children (CHIP) or is pregnant by contacting their state’s Medicaid office.

If an individual or family still has difficulty obtaining adequate health insurance in Texas, they can seek primary care through community health centers which are funded by the health care law. These centers provide services on a sliding scale based on income. While clinics and hospitals have traditionally served as the catch-all for the remaining uninsured population under the ACA, these institutions have been stretched to capacity in recent years due to increasing demand and limited resources.

The likelihood of an individual receiving health insurance in Texas greatly depends on their ethnic background. Persons born as United States citizens who fall in the coverage gap are mostly made up of people of color. Unfortunately, many uninsured adults in the coverage gap who are in fair or poor health put off needed services covered under health insurance in Texas due to the cost. In the long run citizens who can’t afford health insurance in Texas put an added strain on the taxpayer when they go to hospitals or clinics to receive treatment. The disproportionate effect that occurs because Texas has decided not to expand their Medicaid programs becomes more problematic as time goes on.

As a result of the state’s decision not to expand Medicaid programs, the population that falls in the coverage gap who are unable to buy health insurance in Texas under the ACA reflects the ongoing pattern of the system selectively granting Medicaid coverage to only certain categories of people. For example, the large percentage of people who fall outside these categories are mostly men and adults without dependent children. While it’s understandable that someone with dependent children would need health coverage, is it really fair for the law to make the health care needs of those without dependent children less of a priority? If the intention of the Medicaid expansion was meant to end the criteria set for someone under a certain category qualifying for Medicaid, then why are there still so many citizens going without health insurance in Texas?

While an impressive number of enrollments in private health insurance Texas plans were submitted through the federal marketplace, the percentage of the population who actually became eligible for expanded Medicaid was less noticeable. In a nutshell, more people need this form of health insurance in Texas to reduce medical financial burdens among taxpayers. More importantly, the quality and comprehensiveness of health insurance in Texas across Medicaid, marketplace plans, individual plans, and employer-provided coverage, will ultimately determine the degree in which issues with health insurance in Texas are resolved. Then and only then will the citizens of Texas truly benefit from the expanded Medicaid program.