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Highlights and updates
Texas exchange overview
The uninsured rate in Texas is higher than any other state at 16.6%. That number is more than double the national average. The state has the third highest exchange enrollment in the country, coming in behind California and Florida. For 2018, over a million people are enrolled through the Texas Exchange. However, the state opted to not expand Medicaid leaving nearly 638,000 residents in the coverage gap.
In 2017, the state approved the bill S.B.2087 which allows Texas to create a temporary high-risk pool when federal funds become available. The bill prevents the state from using the pool to expand Medicaid and the pool can be used to offset costs for private insurers as well as insure people with pre-existing conditions.
Health Rankings
The Commonwealth Fund’s Scorecard on State Health System Performance ranked Texas 44th. The state ranked poorly in Access and Affordably. The only category they ranked highly in was Healthy Lives including: the prevalence of smoking, the prevalence of suicide, alcohol, and drug related deaths. America’s Health Rankings gave the state 34th place. The state also ranked 2nd when it comes to number of children below the age of 18 who are uninsured.
Rates and Carriers
There were a total of eight insurers for the 2018 year that will all be returning for 2019. Celtic/Ambetter will return with a 4.7% rate increase, Blue Cross Blue Shield a 6.5% decrease, Christus with a 9.6% increase, Molina, with a 7% increase, Oscar with a 17% increase, Sendero with a 33.8% increase, Community Health and lastly, SHA/FirstCare with a 19.9% increase.
Texas and Medicaid
Researchers at New York University estimated that if Texas still has not expanded Medicaid by 2022 Texas will be forfeiting $9.6 billion in federal funds. In just five years, Medicaid in Texas grew by 7%. Texas has strict eligibility guidelines for non-disabled adults without dependent children are ineligible regardless of income and parents with dependent children are only eligible if their household income doesn’t exceed 15% of Poverty which is less than $3,000 annually for a family of three.
Medicare in Texas
In Texas, 13% of the state population is enrolled in Medicare whereas the national average is 17%. 84% of Medicare enrollees qualify based on age and 16% qualify based on a disability. Annually, the state spends about $10,549 per enrollee. As of 2015, 31% of Texas Medicare enrollees opted for a Medicare Advantage Plan. 44% of Medicare enrollees selected a Medicare Part D plan for prescription drugs.
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