Concerns Raised About Texas Health Coverage Program Draft Proposal

Main Category: Health Insurance / Medical Insurance
Also Included In: Public Health
Article Date: 13 Feb 2008 - 12:00 PDT

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Texas health officials and experts have raised concerns about a proposed health care program for low-income residents that would provide coverage for two prescriptions per month, up to five preventive physician visits annually and up to five inpatient hospital days per year, the Austin American-Statesman reports (MacLaggan, Austin American-Statesman, 2/9). The state would divert $246 million from Medicaid funds for safety-net hospitals to create the Health Opportunity Pool, which would provide subsidies based on a sliding scale for residents to purchase insurance (Kaiser Daily Health Policy Report, 12/10/07).

The program would offer coverage first to about 482,000 uninsured parents of children enrolled in Medicaid and SCHIP. Residents with annual incomes up to 200% of the federal poverty level would be eligible for the coverage. State officials said they expect 200,000 parents to enroll in the program within the first year.

Texas HHS Executive Commissioner Albert Hawkins said the program would help ease the reliance on emergency departments and shift the focus to preventive care. However, health experts who reviewed a draft of the proposal questioned whether the proposed benefits were adequate and whether people would enroll in the program. In addition, Ed Berger, vice president of the Seton Family of Hospitals, said the program will not expand coverage to enough residents and its impact on EDs is unclear. State Rep. Garnet Coleman (D) said the program's premiums are too high and the coverage levels are too low, adding, "Why Texas would embark on a program to create more underinsured individuals befuddles me."

Maureen Milligan, deputy chief of staff of the Texas Health and Human Services Commission, said the proposal intentionally provides a low level of benefits to discourage people from dropping employer-sponsored coverage to enroll in the state-sponsored plan (Austin American-Statesman, 2/9).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.