The gift of health insurance

Special to Medical Journal – Houston BY TED SHAW, President/CEO, Texas Hospital Association

Since the start of open enrollment in the federal health insurance marketplace at the beginning of November, more than 220,000 Texans have selected a private health insurance plan.

Some of these Texans are re-enrolling in coverage they purchased last year while others are purchasing marketplace coverage for the first time. Either way, these are important data that show that uninsured Texans – indeed, uninsured Americans – value the availability of affordable health insurance.

Nationwide, during the month of November, more than 2 million Americans in 36 states purchased private health insurance through the federal health insurance marketplace. Texas ranks second in enrollment to date.

This is good news.

But we still have work to do. By January 31, every Texan who purchased coverage last year and would be uninsured without it needs to re-enroll, and every eligible but uninsured Texan who has yet to purchase coverage needs to do so.

There is a lot at stake.

Failure to have health insurance can result in a hefty financial penalty. The IRS can levy a fine of $695 per adult or 2.5 percent of household income, whichever is higher, for being uninsured.

Uncompensated care for Texas hospitals and other health care providers is unsustainably high. Texas hospitals currently carry an annual uncompensated care burden of nearly $6 billion. This is a direct result of the state’s large number of uninsured. This burden not only consumes hospitals’ critical financial resources but increases health insurance premiums for the privately insured and the tax bill for property owners as well.

Being uninsured also is associated with poorer health. Without appropriate access to preventive, primary and specialty care, including prescription drugs and behavioral health services, uninsured patients have no other recourse than the hospital emergency room when a condition becomes too severe to ignore.

Texas hospitals are proud to be leading a statewide effort to get uninsured Texans enrolled in coverage. Through the Insure Health. Insure Texas. campaign, hospitals are getting the message out that affordable coverage is available, and they are connecting uninsured Texans with trusted local enrollment help.

The key message of Insure Health. Insure Texas. is that affordable private health insurance is available. Research on consumer behavior is clear. Consumers approach health insurance purchasing decisions as personal and financial, not political. They want clear, objective information so they can make that financial decision. And the fact is that 80 percent of eligible marketplace consumers will pay less than $100 a month after tax credits for health insurance. Seventy percent will pay less than $75 a month.

Insure Health. Insure Texas. messaging reinforces the availability of tax credits and the financial penalty for being uninsured.

Online tools help consumers find an estimate of what health insurance might cost them and identify local resources to help with the enrollment process. Through the website,, uninsured consumers also can sign up for text alerts and reminders and directly connect with inperson enrollment assistance. The goal is to provide clear, simple, and direct information to reduce confusion and uncertainty and ultimately get uninsured patients the comprehensive health insurance they need.

There is a lot of Texans to get enrolled by the end of January. But, with Texas hospitals leading the way, our state has a real chance to decrease the number of uninsured, reduce uncompensated care, and, most importantly, improve Texans’ health and well-being.