August 30, 2011


Our guest asks:

I was I interested in enrollment for myself and 2 children. I tried to get a quote online, but it stated that there weren't any plans that met my criteria.

OnlineAdviser responds:

Certainly you are not alone. The percentage of Texas residents who can afford health insurance but choose not to enroll is the highest of all states in the country. Based on antidotal feedback through OnlineAdviser service, we suspect that even if and when an individual insurance mandate becomes law, Texas will continue to have a high percentage of uninsured residents. The reason may be simply, as you suggest, that the available health plans don't meet your expectations as a consumer.

There is apparently no quantitatively measurable reason for this state-wide trend. From a comparative standpoint, Texas residents actually have more choices in both medically underwritten insurance (for healthy applicants) and guaranteed issue coverage (for those with significant medical history) than the residents of most other states. Yet Texas residents, as compared with consumers in other states, seem less likely to accept these available choices and more likely to expect coverage terms and provisions that are not available in the market. There is no indication that health insurance coverage in the state is less affordable in comparison with other demographic areas. In fact, the state has slightly less than average health care costs (more detail is included at the link below).

Even the health plans where the government pays part or most of the premium cost (like "Healthy Texas" and the state pre-existing conditions insurance plan) have been met with lackluster reception. Neither the state insurance department officials nor commercial health plan managers seem to have an understanding of this issue and it is now gaining national media attention as health reform initiatives move forward. 

The underlying economic issue is that public and commercial health plans are under increasing pressure to collect more in premium than they pay out in claims. Consumers, in contrast, want a health plan to pay more in claims than they pay in premiums. This issue becomes a major sticking point for individuals who expect to incur claims early in the life of a policy based on their prior medical history or expectations of near-future medical treatment.

In the event of a major change in circumstances at least you may be assured that coverage options are available at http://freedombenefits.net/health-insurance-exchange/Texas-affordable-health-insurance-exchange.html .

Other resources

Alternatives to Healthy Texas

 

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