The Texas Way coverage plan is an alternative to expanding Medicaid eligibility requirements. It is a proposal that would require state and federal government to provide subsidies to more than 1 million Texans falling into the Medicaid Gap so that they can afford health insurance. The subsidies would be used to buy insurance through the federal marketplace and would be provided to Texans earning an income that is less than 100% of the federal poverty level. This plan may be more appealing to conservative Texas leaders because it would still require enrollees to pay a share of their premiums as well as co-pays, and it would fine enrollees who go to the emergency rooms for non-urgent ailments.
The Texas Hospital Association developed the alternative plan, and it would require the Texas Health and Human Services Commission to write a Medicaid expansion waiver and to seek approval from the federal Center for Medicare and Medicaid Services. John Hawkins, the Texas Association's senior vice president for advocacy and public policy, claims, "Basically what we're proposing is that we just redirect the funds for Medicaid expansion under the Affordable Care Act...using those funds to just further private market insurance in the exchange." The Texas Way coverage plan would make subsidies available based on an enrollee's ability to pay. It has not yet been determined whether the subsidies would be tax credits or government assistance. It is also unclear how much state funding the program would require, but the state cost could vary, depending on the number of people who enroll.
Local hospital leaders encourage the proposal because it could relieve them of the $5.5 billion worth of medial care they spend each year on patients who cannot pay. Costs due to uncompensated care also increase Texans' health insurance premiums to an average of $1,800 annually.
Summary by MedicalGroups.com
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