Twenty-One Texas Groups to Congressional Delegation: Pass Meaningful Health Reform This Year

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November 3, 2009

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Joint letter urges meaningful action on health care affordability, highlights utility of public option

Austin, Texas—Twenty-one Texas organizations today submitted the following letter to the Texas congressional delegation strongly urging passage of meaningful health care reform in 2009. These groups organized their effort through Texas Voice for Health Reform, a project that aims to educate Texans and give them a voice in the national health reform debate. The letter urges legislators to take meaningful steps to make health care affordable and conveys the groups’ consensus that a public option is an important tool for achieving affordability.

Below is the full text of the letter.

November 2, 2009

Dear Member of Congress,

We, the undersigned Texas organizations, join together to call on you, our elected representative, to pass strong national health care reform this year. Though we represent diverse organizations, each with specific concerns about the impact of health reform on our respective communities, constituents and members, all of our organizations strongly support a system that guarantees affordable access to a comprehensive standard of care for every American.

Ensuring access to affordable coverage is essential to making the individual mandate and health reform work successfully. Requiring families to buy insurance that costs too much—or requiring them to pay a penalty if they do not purchase coverage because it is unaffordable—will leave millions of Texans uninsured and will fail to deliver on the goal of guaranteeing all Texans access to affordable coverage. This could undercut the public support needed to pass, sustain, and successfully implement reform.

Because Texas ranks first in the percentage of uninsured, our state stands to gain the most from national health care reform. Texans—insured and uninsured alike—cannot wait any longer for meaningful reform. The latest Census data reveal that Texas is home to 10 of the 20 U.S. Congressional districts with the greatest percentage of uninsured. The cost of a family group insurance policy has nearly doubled since 2000 in our state, growing 4.6 times faster than wages, eliminating gains in family income, and eating up employer profits at the same time.

Today, we are pleased that three House and two Senate Committees have approved comprehensive health reform legislation. We know you are working hard in your respective chambers to reach a final bill. As you approach this important work we urge you strongly to please take the following serious concerns related to affordability into account:

  • Adequate limits on out-of-pocket spending must be paired with premium assistance. Hard caps on out-of-pocket spending are needed by Texans at every income level to end the epidemic of medical bankruptcies filed by insured Texans.
  • We are concerned about the very large gap between the affordable premiums proposed in the Senate HELP bills, the somewhat higher family costs in the House bill, and the much higher family costs set out in the Senate Finance bill. Texas’ uninsured population is disproportionately low-income, and to prevent millions of Texans from remaining uninsured despite reform legislation, we urge you to demand limits to the cost of family premiums and out-of-pocket spending as a percentage of family income that are no costlier to families than those adopted in the Senate HELP bill.
  • Our organizations believe that including a strong public option will be a powerful tool to rein in the skyrocketing costs of premiums. A strong public option will increase competition and accountability among insurance companies, and will encourage them to adopt a new business model that prioritizes long-term, cost-effective care and optimum health, rather than short-term profits. The public option will enhance affordability of premiums and out-of-pocket costs, reduce the overall costs of reform, and ensure coverage for the greatest possible number of uninsured Texans.
  • Strong insurance market reforms applied to as much of the private marketplace as possible are needed to make affordable coverage a reality for all Texans, especially for individuals and families who make incomes too high to qualify for premium assistance under reform bills (i.e., above 400% FPL or over $88,200 for a family of 4 in 2009). A key market reform issue for middle-class Texans is limiting how much more an older adult can be charged for the same health coverage as a younger adult. The Senate Finance bill as passed out of committee would allow an older adult to be charged 4 times the price for the same coverage as a younger person. This will make coverage unaffordable for many middle-class adults, and we urge you to support the 2:1 age ratio limit now included in the House bills and the Senate HELP bill.
  • A strong Health Insurance Exchange is also needed to deliver affordable coverage for Texans. To be effective at controlling costs, strong insurance reforms must apply broadly across the insurance marketplace. The new Health Insurance Exchange must have strong market reform tools including standardized benefits, an individual mandate, requiring most coverage to be sold in the exchange, rate negotiation powers, and adequate subsidies to make coverage affordable for low-income families.

Our organizations appreciate all you have done and will continue to do to enact real, meaningful health care reform this year, reform that will make quality, affordable coverage available to every Texan. We stand behind you as you work to finish this critical legislation. Texans cannot wait any longer for meaningful health care reform. It is time to Cover Texas Now! If we may offer information or assistance to you and your staff in the weeks and months ahead, please do not hesitate to contact any of the undersigned organizations.


Texans can send a similar letter to their elected officials by using our online form.

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The Center for Public Policy Priorities (CPPP) is a non-profit, non-partisan policy institute dedicated to improving the economic and social conditions of low- and moderate-income Texans. You can learn more about CPPP at