PUBLIC BENEFITS

Congress should extend Unemployment Insurance through 2011: 1) to protect hardworking Texas families whose breadwinners are struggling to find work after the global economic recession, 2) to protect Texas jobs in an economy only beginning to recover, and 3) to avoid shifting costs to the federal-state public assistance programs, particularly when states faces massive revenue shortfalls. With the so many workers chasing so few jobs, it is far too soon for Congress to cut off Unemployment Insurance. This emergency spending is essential to our economic recovery, and Congress should not require offsetting spending cuts. Public opinion strongly favors Congress acting now to protect families and our economy.

The new national health reform law will change the health care landscape in Texas. Though Texans’ opinions of the new health care reform law cover the full spectrum from approval to those who would have preferred a different approach, the new law is an important tool that states can use to achieve their own health policy goals, such as increasing coverage, improving transparency and quality, and controlling costs.

We commend Executive Commissioner Suehs and the Health and Human Services Commission for the significant progress HHSC has made in improving the performance of the eligibility and enrollment system over the last year. This progress is the result of the infusion of 850 additional workers and a set of policy and procedural changes designed to improve worker productivity. However, sustaining these improvements will be impossible unless the Legislature gives HHSC the staffing and other resources its needs to handle growing caseloads and the implementation of national health care reform in 2014. HHSC’s LAR exceptional items related to staff retention and hiring (#6 and #7) outline these essential needs. Without these resources, the performance of the eligibility system will deteriorate, and Texas will lose out on billions of federal funds that are critical to the health and well-being of our state’s residents and economy.

The year 2009 definitively shows Texas has the most to gain from the health reform law, as Texas remained the state with the highest uninsured rate in the nation at 26.1 percent, or 6.4 million uninsured people, new Census Bureau data show.

The Bureau also released preliminary state-level data showing that poverty rose substantially in Texas, with 428,000 new Texans joining the ranks of the poor from 2008 to 2009; the state's poverty rate rose to 17.3 percent from 15.9 percent.

On July 31, 2009, Stacy Howard and Linda Thornberg on behalf of themselves and all others similarly situated filed a class action in federal district court against the Executive Commissioner of the Health and Human Services Commission for failure to comply with federal timeliness standards in processing applications for the Supplemental Nutrition Assistance Program (SNAP), formerly called Food Stamps.

Thanks to national health reform, Texas now has two separate high-risk pools that offer health insurance to Texans who cannot get coverage in the private market due to pre-existing health conditions: the state-administered Texas Health Insurance Pool, established in 1998, and the federally administered Pre-existing Condition Insurance Plan created by the new federal health reform law.

An important reform of the 2010 Patient Protection and Affordable Care Act launched July 1 when Texans who have been without health coverage for at least six months and who have been denied coverage because of pre-existing health gained access to more affordable, quality coverage. They will receive it through a new Pre-existing Condition Insurance Plan created by the U.S. Department of Health and Human Services (HHS).

There is much work to be done to educate fellow Texans about health care reform, protect it against attacks, and ensure strong implementation of new state roles.

The new federal health reform law will significantly change the health insurance market in the next few years. Changes must occur at the Texas Department of Insurance and the Office of Public Insurance Council as well, as the state takes on new roles and functions necessary to successfully implement the health reform law. The sunset review process provides an opportunity for legislators and the public to rethink the roles of these vital agencies and give them the tools needed to protect consumers and foster competition in a changing health insurance market.

The federal health reform law establishes new accountability measures for unreasonable health insurance premium increases and "medical loss ratios"â€"a measure of how insurers spend premium dollars. CPPP recently submitted public comments to a request for information from federal agencies developing health reform regulations on these topics. The center has done research on rate review and medical loss ratios in Texas, and submitted comments to the federal agencies encouraging strong standards that benefit consumers.

CPPP Senior Policy Analyst Don Baylor presented this testimony on modernizing Texas' unemployment insurance system to the House joint hearing on unemployment insurance and the trust fund.

CPPP joined the Legislative Study Group House Caucus last Thursday for a briefing on health care reform and its impact on Texas. The Event was cosponsored by the Texas Legislative Black Caucus and the Mexican American Legislative Caucus.

CPPP’s Texas Voice for Health Reform team hopes to focus much of our energy over the next several months traveling across the state to help Texans learn about the new health reform law. We know from polling that many Americans still know little about the law, and that support for the new law is high when people learn about what reform will do.

The State Auditor’s office released a report today on the Supplemental Nutrition Assistance Program (SNAP) at the Health and Human Services Commission (HHSC). The report provides a blueprint for restoring access to SNAP (formerly called Food Stamps) and fixing the state’s eligibility and enrollment system for SNAP, Medicaid, and Temporary Assistance for Needy Families (TANF) cash assistance. HHSC’s Executive Commissioner Tom Suehs requested the audit to inform his efforts to end severe delays in SNAP application processing. The delays cause food hardship to tens of thousands of needy Texans struggling to feed their families in the worst economic downturn since the Great Depression.

With more than one in four Texans currently lacking health care insurance and runaway premiums adding daily to that 6.1 million count, relief cannot not come too soon for our overburdened health care system. In addition to providing new economic security to millions of Texas families, the national health reform bill will also bring billions of dollars back to Texas each year through health insurance tax credits for middle class and low-income Texans, and Medicaid coverage for our poorest citizens.

Our state leadership should move promptly and in good faith to facilitate the implementation of health insurance reforms. Texans can look to the establishment of the Children’s Health Insurance Program (CHIP) and our response to Hurricane Ike as recent examples of the excellent performance of which our state government is capable when it has the backing of leadership.

CPPP sent a letter today to the Texas Congressional Delegation urging passage of the health care reform bill. The letter included the real-life health care-related struggles of Sarah, Mario, Andrea, Bruce and Cher, showing how the bill Congress is currently considering will improve their lives and the lives of other Texans just like them.

Passing health reform isn’t just the right thing to do because it will cover many of the uninsured; it will also create tremendous economic benefits for Texas families and small businesses. Health reform makes health insurance coverage more secure, 1) reducing bankruptcies caused by medical bills, 2) allowing entrepreneurs to start new ventures without fear that leaving a current job will mean losing health coverage, and 3) letting small firms operate without providing health benefits while ensuring that their employees still have access to high-quality affordable coverage. Health reform also slows the growth in health care costs, 1) reducing the federal deficit, 2) shoring up Medicare, and 3) allowing employers to increase wages, hire new employees or make other investments in their business with money that would otherwise be eaten up by skyrocketing health insurance premiums. This Policy Page examines the many economic benefits of health reform. For an overview of provisions in the Senate health reform bill, see at the recent CPPP publication What’s in the Health Reform Bills?

Want to prep for the 2/25 health reform summit with a good update on What's in the Health Reform Billsâ€"what they will mean for Texas, and what is happening with them in Washington? Have questions you’d like to get answered?

On February 24 from 10:30 a.m. - 12:00 p.m. CST, the CPPP hosted a webinar to answer all your questions about what's in the health reform bills.

We covered:

• The latest on the debate and process in Washington
• The main building blocks for expanding coverage and insurance reform
• Issues where compromise is still being worked out
• Immediate reforms and Medicare improvements What YOU can do to affect the debate

Click here to view a video recording of the webinar, or click here to download the powerpoint presentation.

CPPP Associate Director Anne Dunkelberg made this presentation, "Texas & National Health Reform: Who Will Gain Coverage? Issues for Texans and State Government," at the Texas Hospital Association's 2010 Leadership Conference on February 17, 2010. The panel, "The Trickle-down Effect: How Health Care Reform will Impact the Texas Budget," included State Sen. Steve Ogden (R-Bryan), and Tom Suehs, executive commissioner, Texas Health and Human Services Commission, Austin.

CPPP Associate Director Anne Dunkelberg made this presentation to a meeting of the Texas Medical Association’s Select Committee on Medicaid, CHIP and the uninsured. The committee includes primary care and subspecialty physicians from across the state and is charged with developing TMA’s regulatory and legislative policy relating to indigent health care, Medicaid, and CHIP.

The Kaiser Family Foundation released mid-January poll results that found Americans squarely divided on national health reform proposalsâ€"at least at first glance. The poll went on to show that large proportions of Americans are unaware of the major provisions of heath reform bills, and their support increases dramatically when told about provisions like tax credits to help small businesses cover their employees, health insurance exchanges where coverage options can be compared; closing the Medicare drug benefit “doughnut hole,” and eliminating denials and rate hikes because of pre-existing conditions.

The sometimes raucous debate over hot-button issues (and outright untruths) of the last 6 months has worked against Americans getting a clear picture of the framework of health reform. This Policy Page provides a high-level outline of the key insurance coverage elements of the Senate bill, noting areas in which compromises with the House are likely.

Texas particularly needs national health care reform: 6.1 million Texans have no health insurance, including 1 in 3 working-age adults and 1 in 5 children. Narrowing the scope of pending legislation to address only health insurance reform won’t help Texas because so many Texans cannot afford health insurance. If Congress abandons two of the key provisions of reformâ€"help with premiums and out-of-pocket costs for low-to-moderate income Texans and Medicaid expansion for working poor adultsâ€"Texas will see very little reduction in uninsured citizens.

CPPP senior food and nutrition policy analyst Celia Hagert delivered this presentation on "fighting hunger, improving nutrition" to the Texas Food Policy Roundtable, a new initiative founded by the Christian Life Commission of the General Baptist Convention of Texas.

CPPP today issued a statement on national health care reform, urging Congress and the Administration to move forward with the reform effort.

As the Senate and House leadership worked to negotiate a compromise national health reform bill, the CPPP’s Anne Dunkelberg made this presentation comparing key coverage features of the bills and illustrating the scope of increased Medicaid enrollment and costs under the 2 bills to the Texas Public Policy Foundation’s Annual Policy Orientation. Medicaid expansion and increased take-up by already-eligible kids will require significant new state Medicaid dollars, but those will be offset with Texas receiving from 10 to 13 new federal matching dollars for each state dollar Texas must contribute.

Last month, Texas Health and Human Services Commissioner Tom Suehs asked the Texas State Auditor to review the agency’s Supplemental Nutrition Assistance Program (formerly known as the Food Stamp Program) operations and recommend changes to address the persistent and severe backlogs and delays in application processing, among other performance problems. The audit presents a critical opportunity to investigate the root causes of the problems facing our eligibility system and identify solutions.

This Policy Page outlines the problems, summarizes recent efforts to resolve them, identifies areas for further investigation, and offers potential solutions.

The Center for Public Policy Priorities and Methodist Healthcare Ministries are pleased to release this updated primer, designed to give readers an introductory overview of factors shaping Texans' access to health care. Readers will be better able to contribute to federal, state, and local debates about how to improve health care access. There are two versions of the primer: The Booklet Version was designed for two-sided printing. The Side-by-Side Version was designed for on-screen viewing.

Every legislative session, Texas legislators struggle to allocate sufficient state dollars to ensure public health. Because of our hit-or-miss approach to health care and our lack of an adequate state revenue system, a higher percentage are shut out of health insurance in Texas than in any other state in the nation.

The following report summarizes how health care fared in the 2009 legislative session. It shows how often Herculean efforts resulted in mostly slight improvements in our state’s public health care structures. For example, while the state took a few small steps forward in funding health care and access to coverage, the session was defined by the high-profile missed opportunities related to the CHIP program buy-in and the Texas Department of Insurance Sunset. Small steps forward are inadequate in light of the health care crisis in our state.

With more than 6 million Texans lacking health insurance coverage and the cost of coverage growing much faster than incomes, Texas needs to take bolds steps to confront barriers to health coverage. Healthy Texas, a new public "reinsurance" program has the potential to put private health insurance coverage within reach of many uninsured Texans. To help the program live up to its goals, a few provisions in the proposed rules related to continuation rights, medical underwriting, and payroll supporting documentation should be modified. CPPP submitted the comments below on the proposed Healthy Texas rules to the Texas Department of Insurance.