The state government of Texas has decided not to implement the health insurance exchange which is mandatory under federal law. Republican Governor Rick Perry strongly opposed the Affordable Care Act and threatened to overturn any legislation regarding the implementation of a Texas health insurance grant.
According to Representative John Zerwas, MD, who sponsored the bill to create the Texas bourse, Governor Perry is emphasizing that he does not want to be involved in implementing health care reform in any way possible.
In contrast, the Texas Medical Association supports the Zerwas bill. Special grants would be offered to those earning 400% of the federal poverty line to help them purchase coverage through the exchange.
In January 2013, the Department of Health and Human Services will examine health insurance grants that have been created by different states. If these are deemed fit to operate under the healthcare reform law by 2014, the states will retain control. Otherwise, the federal government will step in to carry out the health care reform.
Steve Larsen, director of the HHS Center for Consumer Information and Insurance Oversight, says states that don’t approve their own exchange will get a second chance. They do need to send 12 months notice, however.
What is the Texas Health Insurance Exchange Alternative?
Gov. Perry passed a bill to create “Health Collaborations.” Under this bill, healthcare organizations that assume the financial risk to treat consumers will be categorized as TX Health Insurance. Physicians will have the opportunity to participate in more than one of these collaborations.
Another alternative is also making the news. In Camden, New Jersey, which is famous as one of the poorest and most violent cities in the country, an innovative idea has reduced the cost of health care by 40 to 50 percent.
An Obama administration official and two lawmakers have already visited the city to learn about the new strategies. One idea is to bring health care to those who need it most. Two hotspots have emerged as epicenters for the biggest medical bills. One of these areas was an apartment building for 300 disabled or elderly people. The reason health care was so expensive here wasn’t the sheer volume, but expensive emergency care was replacing preventive care. They’ve turned the cost of health care upside down here by adding a nurse’s office in the building.
Having regular preventive check-ups not only saved money, but also improved the quality of life for many apartment residents because they received better care than available in the ER.
Will a Texas Health Insurance Scholarship Improve Preventive Health Care?
The health insurance swap also serves to get people who previously couldn’t afford TX health insurance out of the ER.
If one of the poorest cities in the country can reduce medical costs by 40 to 50 percent while improving the quality of health care and reducing the need for health care, what stops other cities? Are those who profit from expensive emergency care holding us back?