March 1, 2013 – A faculty health care expert at the University of Houston Law Center told members of the Houston business and legal communities Wednesday that big change is on the horizon for individuals lacking health insurance come 2014. Professor Patricia Gray's presentation "Affordable Care Act: What it Means for Texas" was part of the Law Center's Legal Excellence speaker series.
"Beginning in 2014, people without health insurance will have the option of purchasing insurance through health insurance exchanges, basically Internet-based markets for insurance," said Gray, the director of research in the Law Center's Health Law & Policy Institute. "Plans participating in these exchanges must provide comprehensive coverage and cannot exclude pre-existing conditions."
They also must offer their plans to all seekers, that is, they cannot reject an individual simply because they are high-risk. Plans participating in the exchanges generally cannot increase premiums based on health status. There will also be limits on premium increases as people age.
Several of the provisions in the act have already benefitted Texans, Gray noted.
"More than 5,600 Texans previously denied coverage have been able to gain coverage through the Pre-existing Conditions Insurance Plan," Gray said. "Also, insurers rebated more than $127,000,000 to more than 650,000 Texans. And, more than 350,000 young adults have been allowed to stay on their parents' health plans."
Many of the uninsured in Texas could be covered under an expansion of the Medicaid program should Texas elect to do so. Other options include health insurance exchanges, or Small Business Health Options Program.
Law Center alumnus Ken Janda '81, president and CEO of Community Health Choice, Inc. a Houston-based managed care organization that provides managed healthcare plans focused on low-income families, elaborated on the insurers perspective.
"There will be big changes in the individual market," Janda said. "The provisions of ACA aren't perfect, but it time for Texans to roll up their sleeves and implement health care reform."
Janda contended that the small employer insurance market might disappear entirely. He also believes there will be a growing trend toward self-funded insurance plans for large employers.
"Going forward the discussion needs to be focused on value," said Leon J. Leach, Ph.D., executive vice president of MD Anderson Cancer Center Business Affairs. "From a provider and employer perspective, we will have to do more with less. This will be particularly challenging."
UH Regent and Law Center alumnus Jacob M. Monty '93 attended the event. Co-Director of the Health Law & Policy Institute and Assistant Professor Jessica L. Mantel moderated the discussion.
The series will feature two additional lectures by Law Center professors. Topics include:
The lectures are free and open to members of the Houston business and legal community. One hour of participatory CLE credit will be awarded to attorneys in attendance. All lectures will be held from 11:30 a.m. to 1 p.m. at the
Hilton Americas Hotel in Houston, 1600 Lamar. Please RSVP to firstname.lastname@example.org or call 713-743-2107.