Texas Business Group Calls for Change in Ins. Laws

September 10, 2004

Three-fourths of uninsured Texans have full-time jobs but cannot afford health insurance, according to a report released recently by the Texas Association of Business.

The study also shows that more than half of Texans without health coverage live in households earning more than $75,000 a year.

The statistics show the need for changes to the state’s insurance laws to combat the soaring costs, said Bill Hammond, president and CEO of the Texas Association of Business, which represents more than 140,000 small and large companies and 200 chambers of commerce.

“Businesses are struggling to provide their employees with health insurance,” Hammond said Wednesday at the group’s conference on health-care issues.

Texas has the highest rate of uninsured non-elderly residents, about one-fourth of the state’s population, according to U.S. census data. Some 4.8 million Texans had no insurance in 2003, an increase of 300,000 from 2002, according to the National Academy of Sciences.

In its report called “Texas Health Care in Crisis: No Easy Cure,” the group asks state lawmakers to expand a 2003 law allowing insurance companies and HMOs to offer lower-priced plans that exclude benefits previously required by the state–benefits the group says have run up costs.

“The question is–is it better to have some insurance or none at all?” Hammond said.

Such “consumer choice plans” are primarily intended for individuals and small employers. Hammond said the new law was an important step toward more affordable insurance, but his group wants lawmakers to exempt companies from more requirements–including paying half of costs when an employee goes to a doctor outside a network.

Consumer advocates have said the state must continue to require HMOs to cover services related to certain major illnesses.

Dr. Robert W. Sloane, a Fort Worth trauma surgeon and a member of the Texas Medical Association, said the business group’s recommendation “sounds like a great idea” unless the consumer choice plans offer so few benefits that gaps in coverage still exist.

“One needs to make sure you’re not subtracting benefits that help the entire population and make sure the consumer knew exactly what he was getting,” Sloane said.

The Texas Association of Business also recommends that the state adopt a more enforceable health-care fraud statute modeled after the Texas Deceptive Trade Practices Act.

The group and others also want the state to create a consumer right-to-know act providing access to information about the cost and quality of health care, as well as data about doctors’ and hospitals’ medical errors.

“This information is in what we call a black box, and that’s what needs to be opened,” said Marianne Fazen, president of the Texas Business Group on Health.

Copyright 2004 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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