Legislature pursues innovative bipartisan health care
Smart health care policy focused on access to affordable care is happening in Texas.
With each passing year, access to affordable health care is a barrier to more and more Texas families and a greater strain on employers’ budgets. The Texas Legislature is taking steps to address this through innovative, bipartisan action to foster competition, create more transparency and encourage a healthy market for health care.
This week, House Bill 711, by state Rep. James Frank, R-Wichita Falls, and co-authored by state Reps. Sam Harless, R-Spring, Greg Bonnen, R-Friendswood, and James Talarico, D-Round Rock, passed 146-0 in the Texas House. It seeks to address a leading cause of higher prices — an unhealthy market consisting of high market concentrations and business practices that limit choices and innovation.
Currently, the total cost of employer-sponsored insurance averages $22,000 per year, which is nearly one-third of the median household income in Texas. These rising costs can be attributed, in part, to Texas’ hospital market consolidation, which is well above the national average.
HB 711 is just one of a package of health care bills designed to make the state’s health care markets healthy through a more informed, competitive and engaging system.
The bills under consideration in the Legislature offer innovative approaches to creating healthy markets: expanding existing price transparency requirements, improving the availability of information on provider quality, empowering patients to be smart shoppers, and rewarding them when they are. These bills will benefit millions of Texans who are currently struggling with high health care prices.
“Texans deserve access to affordable, high-quality health care, and the Legislature is taking important steps towards making this a reality,” said Charles Miller, Senior Policy Advisor for Texas 2036. “This package of bills aims to provide Texans with choices and enough information to make the right choice, while ensuring that they’re rewarded for doing so. Given the potential benefit these efforts will have on everyday Texans, we hope more people will be able to engage in the conversations around health care reform.”
The bills under consideration would help improve the three requirements for healthy markets: transparent information, abundant competition and aligned incentives. The bills under consideration address all these issues and offer a path forward toward affordable, high-quality health care for all Texans.
“Texas legislators are taking important steps to ensure future Texas health care markets are healthier than today,” said Miller. “Texans need to be able to get the care they need, when they need it, at a price they can afford.”
Elements of the Healthy Markets Plan:
I. Informed markets must have transparency of information on both price and quality.
Too many Texans still can’t get meaningful price estimates in advance of medical services, a problem that is addressed by House Bill 3218 by Rep. Stephanie Klick, while Sen. Lois Kolkhorst has authored Senate Bill 945, which expands existing price transparency requirements to a broader scope of providers. Insurers are prohibited from offering enrollees information on the quality of providers, a problem addressed by House Bill 3351 by Rep. Caroline Harris. Lastly, many Texans saddled with medical debt are unable to understand their charges. House Bill 1973 also by Rep. Caroline Harris (with a Senate companion Senate Bill 490 by Sen. Bryan Hughes) ensures that patients will receive an itemized, plain-language bill.
II. Competitive markets must provide choices.
Texas’ hospital market consolidation is well above the national average – with over 60% of our population living in a highly or very highly concentrated market. The negative impacts of this consolidation are spilling over into primary care services as independent physician practices are acquired by large health systems. House Bill 1692 and Senate Bill 1275 by Rep. James Frank and Sen. Kelly Hancock reduce incentives for health systems to buy physician practices, helping to also limit the growth of hidden facility fees for telehealth care.
House Bill 3411 by Rep. Greg Bonnen would reform non-compete agreements. House Bill 1001 by Rep. Giovanni Capriglione would allow insurers to offer additional options to better meet consumers’ needs. And House Bill 2002 by Rep. Tom Oliverson helps empower the 80% of patients who haven’t hit their deductible to be smart shoppers, regardless of whether a provider is in or out of their insurer’s network. Creating a market of cash buyers could also make it easier for new business models to enter the market, providing patients with more choices.
III. Lastly, healthy markets must be engaged.
Engagement in health care markets means that both patients and providers are appropriately incentivized to make beneficial decisions. Because so much of health care is paid for by third parties — employers and insurers — it is crucial to make sure that these health benefit plans may be structured in ways that create appropriate incentives.
Employers and health plans are sometimes prevented — by state law and large health corporations — from providing incentives that reward customers for choosing lower-cost, higher-quality options. House Bill 711 and House Bill 2414 by Rep. James Frank address these issues, freeing employers and insurers to design more intelligent benefit plans, while ensuring that they act in the best interest of their enrollees as fiduciaries.
Texas is well positioned to act.
The 88th Legislature has an opportunity to build upon existing price transparency requirements, eliminate restrictions preventing disclosure of quality information, address the growing impact of consolidation and market power, and limit the potential of private equity from adding hidden fees to your bill.
They can also 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.
Over the years, Texas legislators have been adopting measures around hospital price transparency and the elimination of surprise medical bills. Prioritizing healthy markets is the single most important thing the state can do to help empower employers to provide more affordable health care for their employees during this legislative session.
Learn more about healthy markets at texas2036.org/healthy-markets.
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