Browsing by Author "Bray, Patricia Gail"

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    Health Reform Monitoring Survey – Texas, Issue Brief #1
    (James A. Baker III Institute for Public Policy;Episcopal Health Foundation, 2014) Ho, Vivian; Marks, Elena M.; Bray, Patricia Gail; James A. Baker III Institute for Public Policy
    In September 2013, as the nation prepared for the launch of the Affordable Care Act’s Health Insurance Marketplace, Texans were surveyed to learn about their recent experiences with health care and health insurance and their expectations going forward. This Issue Brief describes Texans’ experiences obtaining and paying for a variety of health services during the preceding year and the satisfaction levels of insured Texans with the quality and cost of their health plans. These data show that, on the eve of the launch of healthcare.gov, many Texans were struggling to pay for basic health services. Even those with health insurance reported dissatisfaction with the cost and availability of services. And most Texans expected 2014 to be more of the same.
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    Health Reform Monitoring Survey – Texas, Issue Brief #2: The Affordable Care Act and Texas’ “Young Invincibles”
    (James A. Baker III Institute for Public Policy;Episcopal Health Foundation, 2014) Marks, Elena M.; Bray, Patricia Gail; Ho, Vivian; James A. Baker III Institute for Public Policy
    One of the goals of the Affordable Care Act (ACA) is to increase the number of young adults with health insurance coverage by offering comprehensive plans at affordable prices through the Health Insurance Marketplace. Participation in the Marketplace by young adults is important because it facilitates access to health care and protects against high, unexpected medical bills. The inclusion of younger, generally healthier people in the insurance risk pool helps the entire system by offsetting the costs of health services used by older and less healthy people. As the first enrollment period of the ACA’s Health Insurance Marketplace comes to a close, special attention is focused on extending health insurance coverage to people ages 18-34. This group is often referred to as the “Young Invincibles,” a term coined by the health insurance industry to describe young adults who forego health insurance believing that they are too healthy to justify the cost of coverage. This issue brief highlights HRMS-Texas’ findings about the Young Invincibles’ knowledge and perceptions of the ACA immediately prior to the opening of the Marketplace. We also report data regarding insurance status and affordability and accessibility of health services for young adults. The substantial number of uninsured Young Invincibles in Texas—2.3 million people—provides challenges and opportunities for the ACA.
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    Health Reform Monitoring Survey – Texas, Issue Brief #3
    (2014) Ho, Vivian; Marks, Elena M.; Bray, Patricia Gail; James A. Baker III Institute for Public Policy
    The major provisions of the Affordable Care Act influencing health insurance coverage took effect this year. Residents of all 50 states who could not obtain affordable health insurance through their employer or in state insurance markets can now purchase coverage through the ACA’s Health Insurance Marketplace. Families earning between 100% and 400% of the federal poverty level are eligible for subsidies to purchase insurance in the Marketplaces. Individuals in families earning less than 138% of the federal poverty level are eligible for Medicaid if the state they live in elected the Medicaid expansion offered by the ACA. Under the law, almost all individuals are required to obtain health insurance coverage by March 31, 2014, or pay a penalty levied by the IRS in their tax return for 2014. Given that Texas has consistently had the highest percent of uninsured residents among the 50 states for several years, the insurance provisions of the ACA are expected to play a substantial role in providing coverage to the close to 5 million adults who reportedly lacked health insurance in the state in 2010-2011. However, technical problems plagued the electronic websites for the Health Insurance Marketplaces in each state when they opened in October 2013, and some of these problems still exist today. In addition, Texas declined the Medicaid expansion offered by the ACA, so that most adults in families earning less than 138% of the federal poverty level are ineligible for any public subsidies to purchase health insurance. In this brief, we track changes in health insurance status in Texas between September 2013 and March 2014. We find that the rate of uninsured adults ages 18 to 64 in Texas declined from 24.8% to 23.5%. The majority of this decline is attributable to an increase in the percent of adult Texans obtaining insurance through an employer. The proportions of adults with either Medicaid or individual private insurance both declined during this period. However, these percentages likely disguise significant changes in insurance coverage in Texas over the time period. By mid-March 2014, an estimated 746,000 Texans had obtained private insurance through the Marketplace. Of these, 225,000 (30.2%) were previously uninsured. Although a seemingly small proportion of Texans obtained insurance through the state’s Marketplace, the large absolute numbers had a substantial impact on increasing access to insurance coverage in the United States.