Healthy markets: Getting Texans the health care they need

This is a preview of our Texas 2036 newsletter about healthy markets and getting Texans the care they need. To receive this weekly highlight of our work, sign up here.

For far too many Texans, health care has become unaffordable—to the point of being unobtainable. Here’s a look at our treatment plan, a diagnosis of what’s driving higher health care prices and concrete steps that policymakers can take today to address high prices across Texas.

Healthy markets: Health care access for Texans 🏥

Setting the stage: Barriers to affordable health care are preventing Texans from accessing needed care, contributing to unhealthy outcomes and high rates of medical debt.

  • The high price of health care—even among those with insurance—is causing more than half of Texans to skip the care they need.

Cause for concern: These prices are partly the result of unhealthy markets created by anti-competitive practices.

  • 61% of Texas’ population lives in “highly” or “very highly concentrated” hospital market concentration, as compared to 3% in California and 10% in Illinois.

Did you know: Nearly one-third of Texas adults—6.2 million Texans—have unpaid medical bills.

  • Average annual premiums to cover a family on employer plans in Texas are more than $20,000—that’s one-third of the average Texas household’s annual income.

👉 Read more: Concentration, competition and cost: How are the hospital markets of Texas?

Moving forward: Addressing health care trends 🩻

Time for change: There is strong demand for the Texas Legislature to lower the cost of health care, which they can address this legislative session with House Bill 711.

  • With healthy markets, Texans are able to get the care they need, when they need it, at a price they can afford.

Breaking it down: Healthy markets must be informed, competitive and engaging. This means:

  • Informed markets need transparency: Too many Texans still can’t get meaningful price estimates in advance of medical services.
  • Competitive markets provide choices: Texas’ hospital market consolidation is well above the national average.
  • Market engagement requires smart incentives: Currently, employers and health plans can be prevented from providing incentives that reward customers for choosing lower-cost, higher-quality options.

👉 Dive deeper: Health price transparency: A timeline and explainer

Taking action: Texas legislators have been adopting measures around hospital price transparency and elimination of surprise medical bills. Here’s what the 88th Legislature can do:

  • Build upon existing price transparency requirements.
  • Eliminate restrictions preventing disclosure of quality information.
  • Address the growing impact of consolidation and market power.
  • Limit the potential of private equity from adding hidden fees to your bill.
  • Ensure when health benefit plans encourage enrollees to obtain a health care service from a particular provider that they do so for the primary benefit of the enrollee.

👉 Learn more: Healthy markets: A treatment plan for addressing health care markets

Spotted at the Capitol 🏛

Last week, Senior Policy Advisor Charles Miller testified before the Texas House Select Committee on Health Care Reform in favor of House Bill 711.

The bill offers a solution to anti-competitive contracting and conduct affecting health care provider networks.

🎥 Watch his testimony: Texas 2036 addresses one of the underlying causes of high health care prices in TX

It’s your turn, Texas! 

Have you experienced high health care prices? 🧐

Share your story.