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What’s next for reducing the number of uninsured in Texas?

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

Texans without health insurance have the remainder of January to purchase private coverage from the federal health insurance marketplace, healthcare.gov, and, depending on their income, qualify for tax credits to reduce the cost of that coverage.

So far, nearly 1.2 million Texans have enrolled. This is more than the total number who purchased coverage in 2015, positioning the state possibly to enroll close to 2 million residents by the end of open enrollment. As a result, Texas could further reduce its uninsured rate that already fell from 22 percent in 2013 to 19 percent in 2014.

Improvement to be sure, but we still have work to do.

Texas continues to lag behind other states in reducing the number of uninsured residents. For a variety of reasons, the state still leads the nation in both the number and percentage of residents without health insurance. Part of the reason is inaction on the part of state leadership to provide a means for low-wage working Texans to get health coverage, either through traditional Medicaid expansion or a private alternative. The result is that more than 1 million Texans lack access to affordable health insurance. Figuring out a path forward to affordable coverage for these Texans is important not only to reduce the number of uninsured but to keep our workforce healthy and productive and our economy strong.

In addition, we still have work to do because an insurance card by itself is not a guarantee of access to care or improved health care outcomes. We know that for some residents with marketplace insurance, high deductibles and cost sharing are a burden. If the insurance is too expensive to use, it is not useful. We also know that for others, narrow provider networks are limiting access to needed specialists and facilities. These are both issues that we need to apply our collective will and thought to improve.

Fundamentally, however, for patients and providers alike, more insured Texans is a good thing. Clinically and financially, our health care system works better when more people are connected to the health care delivery system and are not on the fringes, delaying needed care and relying on hospital emergency departments.

Texas hospitals understand this fact and have long been committed to reducing Texas’ uninsured population. Most recently, during open enrollment for 2016, they are leading an effort to enroll as many eligible but uninsured Texans as possible in marketplace coverage through the Insure Health. Insure Texas campaign. Using the campaign’s resources, Texas hospitals of all sizes are delivering the key messages of health insurance affordability and availability. Through social media, radio ads, billboards, digital ads, and direct mail to uninsured patients, Texas hospitals are covering the state with the simple but highly effective message that affordable health insurance is available. The insurehealthtx.org website sees daily traffic from individuals from Childress to Fort Worth to Houston to Laredo and cities in between.

Our work does not end on Jan. 31 just because open enrollment ends. As trusted members of their communities, Texas hospitals will continue to advocate for further reductions in the number of uninsured, help the newly insured understand and appropriately use their health insurance coverage and work to eliminate barriers that impede meaningful access to needed health care services.