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Texas health insurance exchange

texas guide to health insurance

Texas enrollment second highest among states with HHS-run exchanges

March 31, 2013

Open enrollment in Texas ends on March 31.  But HHS is allowing an extension for applicants who begin the process by that date, but are unable to complete their enrollment by the end of the day on March 31.  The extension is expected to be valid until mid-April, and applicants will have to attest to the fact that they tried to enroll by March 31 but were unable to finish because of technical problems or other extenuating circumstances.

Enrollment in the Texas exchange skyrocketed to 295,025 by March 1 – the second month in a row with an increase of nearly 90,000 people.  The total in Texas was the second highest of the states where HHS is running the exchange, trailing only Florida.

An additional 94,954 exchange applicants had enrolled in Medicaid during the first five months of open enrollment, despite the fact that Texas is not expanding Medicaid under the ACA (those applicants were already eligible under existing rules).  Total enrollment – including private plans and Medicaid – stood just shy of 390,000 on March 1.

CMS announced on November 22 that Texas applicants can enroll in QHPs directly through insurers – bypassing the exchange website entirely –  with premium and cost-sharing subsidies available for eligible enrollees (the federal data hub is used to verify identity and determine subsidy eligibility for enrollments that go directly through insurance carriers).

Amid concerns over the problems that beset in the first several weeks of open enrollment, Texas Insurance Commissioner Julia Rathgeber announced on November 22 that the state-run high risk pool would remain in existence until March 31, 2014.  It had originally been scheduled to close at the end of December, but it was unclear whether all 23,000 members of the pool would be able to secure coverage through the exchange in time to have January 1 effective dates.

Texas Gov. Rick Perry formally notified the Department of Health & Human Services (HHS) in July 2012 that Texas would not implement a state-run health insurance exchange. In his notification letter, Perry —a long-standing opponent of the Affordable Care Act — called the ACA provisions “brazen intrusions into the sovereignty of our state.”  In early January, the Perry Administration’s efforts to make it more difficult to be a navigator in Texas drew criticism from ACA supporters and Democratic lawmakers, who claim that Perry is simply trying to impede enrollment in the Texas exchange.

Texas State Representative Eric Johnson, a Democrat from Dallas, did introduce bills in early 2013 that would have created a state-run exchange and expanded Medicaid, but neither was successful.  HHS is running the exchange in Texas, and the state is not expanding Medicaid.

Premiums in the Texas exchange are less than the national average.  Averaged for all age groups, the lowest cost bronze plan in the Texas exchange is $211/month, compared with a national average of $249/month.  That’s good news for Texas residents, but the technological problems that have plagued throughout October have hampered enrollment.  Twelve carriers are offering a total of 95 different health plans in the Texas exchange, so residents have many options from which to choose and competition among carriers is helping to keep the rates below the national average.  Not only are there a wide range of plans available in Texas, but there are also several big-name health insurance carriers participating in the Texas exchange, including Aetna, Cigna, Blue Cross Blue Shield of Texas and Humana.

According to the U.S. Census Bureau, 25% of people in Texas are uninsured — the highest rate in the nation. A report prepared by the Hobby Center for the Study of Texas at Rice University estimated that 3 million people could gain coverage by 2014 if the state implemented the provisions of the Affordable Care Act.  But with the state’s current refusal to expand Medicaid, approximately one million of those people will fall into a “coverage gap” (and likely remain uninsured) because they earn too much to qualify for Medicaid but too little to qualify for subsidies in the exchange.

According to a Kaiser Health News article, Blue Cross Blue Shield of Texas is playing a major role in educating state consumers about the federal health insurance marketplace. The Blues plan is using many strategies to reach consumers: creating a website, launching a texting campaign, and engaging churches, community clinics, nonprofits, and other community organizations.

Texas health insurance exchange links

Be Covered Texas

Federal Health Care Reform Resource Page
From the Texas Department of Insurance

Texas Health Options

State Exchange Profile: Texas
The Henry J. Kaiser Family Foundation overview of Texas’ progress toward creating a state health insurance exchange.

TX health insurance exchange news

State-by-state open enrollment extension details

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Texas medical offices putting in overtime to verify patients’ ACA coverage

In Texas, medical offices are spending considerably amounts of time on hold to verify…

Thanks to a loophole, many Texas navigators are now called certified application counselors

Texas Governor Rick Perry is fiercely opposed to the ACA, and asked the DOI to require…

Nineteen states have imposed stricter rules on exchange navigators

Nine states have refused to expand Medicaid and have also created rules that make it more…

Texas pushed for more training, tougher standards for exchange navigator certification

Texas officials are trying to enact tougher standards, including background checks and…

Texas extends its high risk pool until March 31

Amid concerns that the 23,000 Texas residents who are covered under the state’s…

Texas insurers part of pilot program to enroll residents in QHPs directly through insurance carriers

CMS has announced that Texas is one of three states where people can now enroll directly…

17 million eligible for health insurance subsidies

Kaiser Health News — A new analysis estimates 17 million people who are currently…

Roadblocks for navigators in red states

National Journal — Republican governors, insurance commissioners and legislatures have…

States’ refusal to expand Medicaid leaves 5.2 million without health insurance

Bloomberg — Twenty-six states refused to expand Medicaid coverage through the…

Voice your concerns to your
Texas elected officials

tell your elected officials

Let your Texas governor and legislators know how you feel about the state’s proposed health insurance exchange.

Texas Governor Rick Perry
P.O. Box 12428
Austin, Texas 78711-2428
PHONE: (512) 463-2000
FAX: (512) 463-1849
Contact by e-mail
Contact your Texas State Senator
Contact your Texas State Representative