Blue Ribbon Task Force on the Uninsured Met at Valley Baptist Hospital in Harlingen
HARLINGEN - The Blue Ribbon Task Force on the Uninsured met at Valley Baptist Hospital in Harlingen on Thursday, January 20, 2000. The task force is examining the state's health insurance regulation, and the make up of health insurance policies.
The task force comprises nine members: Senator Chris Harris of Arlington serving as Chair, Senator David Bernsen of Beaumont, Representative Garnet Coleman of Houston, Dr. Nancy Dickey of Bryan, Representative Craig Eiland of Dickinson, Representative Bob Glaze of Gilmer, Dr. John Goodman of Dallas, Mr. Boone Powell of Dallas and Senator Eliot Shapleigh of El Paso. Also joining the task force for this meeting was Senator Eddie Lucio of Brownsville, who welcomed the members to his district, saying that high unemployment in the Rio Grande Valley makes affordable health insurance an especially important issue to the region's rapidly growing population.
The task force began with invited testimony on health insurance regulation. D. Mark Weinberg of Unicare Life and Health Insurance was first to testify. He said that both the sick and the healthy have to participate in a health plan, or it won't be solvent. Weinberg also said that health plans that allow patients to pick up a portion of the cost are where the future health insurance market is headed. Chairman Harris questioned Weinberg on reports that certain health plan administrators are making anywhere from one to 60 million dollars a year. Chairman Harris stated that these administrators might need to control their own, in-house costs.
Dianne Longley, of the Texas Department of Insurance, testified on the difficulty of offering insurance to people who work for small employers. Rhonda Myron, also of the Dept. of Insurance, testified that the state cannot regulate all plans, due to federal regulations, and others.
Former Senator Jerry Patterson, representing the Texas Association of Health Plans, also addressed the task force. He stated that about 24% of Texans are uninsured, and that number could be reduced by about a third. Patterson said that although some Texans--such as the chronically unemployed or homeless--will always be paid for by the public, it's not conveniently available to others. And, there are also some people who simply refuse to purchase it. He says that insurers and their policyholders eventually wind up paying for every Texan who can't or won't pay for their medical care.
Mike Pollard, from the Texas Association of Life and Health Insurers, gave a history of health insurance in Texas. He said future medical treatments, such as artificial hearts, could cost hundreds of thousands of dollars. Pollard also testified that we need to know what these costs will be and we need to identify those who are uninsured, and design policies that they can afford.
Kathy Mitchell, representing Consumers Union, and a number of other groups, said that some public subsidy is required to make insurance reform work for everybody. She said that the pooling of risk is necessary, so all policyholders can share the costs.
Regarding the development of health insurance policies and how they are sold, the members heard from Bob Walton of the Texas Association of Insurance Agents. Walton said that today's can't be explained in just one meeting with potential policyholders, but that almost everyone who doesn't have a medical condition can qualify for a policy.
Lou Cattana, from the Texas Association of Health Underwriters, said that, speaking strictly as an agent, some fees for service plans don't work. This is because those plans don't get the same price breaks that Health Maintenance Organizations or Preferred Provider Organizations do.
Gilbert Pena, of the Texas Association of Insurance and Financial Advisors, told the members that when the state orders companies to cover certain diseases, prices go up and people tend to not buy insurance. He said certain studies show that chemical dependency coverage alone increases cost by almost 10%.
Public testimony followed. Dora Cepeda, a Harlingen resident, told of how her daughter had been struck by kidney disease. When Cepeda started a new job, her daughter was denied coverage when the company called her daughter's condition pre-existing. Cepeda also couldn't afford full insurance coverage, and at the same time didn't qualify for public assistance. She said her family would have been financially ruined without the help provided by the Rio Grande Valley community health center for migrants, Su Clinica Familiar.
Leticia Morales then testified. She is a widow with four children, one disabled, and cannot qualify for assistance. She is concerned that one child will need medical care that she cannot provide, since she cannot afford insurance. Like Dora Cepeda, Morales doesn't qualify for public assistance. Task force members suggested she investigate the new Children's Health Insurance Program (CHIP), which may be able to help.
Maria Delgado, of Harlingen, said she also has disabled children, two. Delgado doesn't qualify for public assistance and can't afford private insurance.
Rosie Skinner, of San Benito, testified that all three of her children are patients at Su Clinica Familiar, one with a liver disease. After Skinner was given a $20 dollar raise, her Medicaid benefits were cut off.
Frank Vasquez, of Su Clinica Familiar, told the members that his operation serves 25,000 persons a year. In Cameron and Willacy Counties alone, a third of the people have no health insurance at all. Half of that third are children. Even worse, the number of uninsured at his clinic is increasing, and he has hundreds of people on a waiting list. When the uninsured finally do get an appointment, they have multiple problems, requiring expensive care. He said it's difficult to qualify people for Medicaid coverage and that CHIP insurance program will help a little.
Dr. Ruben Martinez, a Harlingen OB/GYN, testified that the uninsured indigent cannot afford health care or insurance. Furthermore, they can't even afford to travel to San Antonio or elsewhere for treatment. He says local problems in the Rio Grande Valley could be solved by the creation of a local hospital district. He also criticized the state's Health Department for its plans to close down South Texas Hospital, a place where he has admitted the indigent in the past.
Bill Adams, of Valley Baptist Medical Center, testified there is no public hospital in the Rio Grande Valley, so the private hospitals must pick up the slack. In one year, Valley Baptist alone had to write off more than $23 million in hospital care due to uninsured patients who couldn't pay their bills.
Patricia Fogerty, of McAllen, testified that the infrastructure of the Rio Grande Valley is not capable of handling all the people who need assistance.
Dr. Stan Fish, of Harlingen, testified that about 20% of his patients have to pay for their care out of pocket. They can't purchase insurance, because they simply cannot afford it. He asked that the Texas Legislature encourage local governments to cooperate on making indigent care more available.
The committee was scheduled to recess subject to call of the chair, with its next meeting to be announced at a later time and date.