If health care reform survives, residents could see a reduction in the cost of Texas health insurance premiums. That’s because a major part of health care reform requires insurers spend more on their members or give them a refund.
Texas insurance plans are now required to spend at least 80 percent of the revenue they bring in on medical care for members. The remaining 20 percent may be used for administrative needs, commissions to bring in business through agents and brokers, or advertising and marketing efforts. Because this new requirement limits profits, big business is fighting reform.
As long as health reform is not overturned, insurers that keep excessive profits or spend more than 20 percent of premiums for anything other than members’ health services will owe refunds. Such rebates could be returned to members by check or via a credit on premiums. These refunds will be due by August 1, 2012.
Because group health insurance for Texas plans typically retain less than 20 percent of members’ premiums, no refunds are anticipated on group coverage. Texans who have to pay for their own coverage in what’s known as the individual market are the ones who will receive rebates.
How Likely Are Refunds On Individual Texas Insurance Plans?
Rebates on health insurance in Texas are mandated by the reform law that is being challenged in the courts. Texas Attorney General Greg Abbott joined with 20 other state coalitions to file suit in the Federal District Court in the Northern District of Florida to oppose federal reform.
Judge Vinson rejected the federal government’s motion to dismiss the States’ case and in a sister lawsuit in the Commonwealth of Virginia, a federal judge ruled that the mandate to maintain minimal coverage is unconstitutional. This mandate is the model for universal health care seen in most developed countries, and it may be necessary to bring the U.S. up to the standard set around the world.
Can Texas Help Individuals Get Coverage?
Texas state government officials are facing a major monetary shortfall of up to a $24 billion. Yet, a recent public opinion poll shows the majority of voters support health care protection for children and low-income families.
A recent newspaper poll commissioned by the Austin American-Statesman of 819 Texas residents included 716 registered voters. They were polled by phone at the end of December 2010. Approximately 61 percent of the respondents wanted to retain current spending levels for programs that provide health care to children and families with moderate or lower incomes.
Even the most optimistic budget estimates require cutting the budget by 15 percent, according to analyst Eva DeLuna Castro. She’s with the Center for Public Policy Priorities that advocates for those with low-incomes in Texas. Without health care reform, Texas residents may be on their own to find health insurance in Texas.
Individuals Can Get Texas Health Insurance Coverage With Low Premiums
If you’ve lost your group coverage through employment, you need to know three things to find low-cost individual policies. First, high-deductible policies generally cost less. Before health care reform, these policies were criticized because policyholders tended to give up regular preventive care. This resulted in too many diseases progressing without treatment.
When health care reform passed in March 2010, insurers were required to cover recommended preventive services at 100-percent. Individuals who purchase Texas health insurance now can get yearly checkups, including screenings for common cancers, diabetes and high blood pressure with no co-pay charges whether they have met their deductible or not.
In Texas, health insurance for individuals under the age of 30 is especially inexpensive. A Blue Cross plan called Tonik offers three low-cost coverage options. Rates can be from $64 to $123 a month, depending on medical history and where you reside in Texas. The rates are good for those over 30, too, but the plans only cover healthy individuals.