One-third of Hispanic Texans Lack Medical Insurance in 2016
In total numbers, these statistics show that about 2 million Hispanics across Texas still do not have medical insurance.
By - There is still more work that needs to be done to ensure all American citizens have access to healthcare coverage. The Episcopal Health Foundation and Rice University’s Baker Institute for Public Policy found that approximately 32 percent of Hispanic citizens in the state of Texas aged 18 to 64 still lack medical insurance, according to a company press release.
While the Affordable Care Act and its provisions has brought the uninsurance rate among Hispanic Texans to fall by 30 percent, there is still more that needs to be done to ensure this particular population has access to medical insurance and healthcare services. While in September 2013, 46 percent of this population lacked healthcare coverage, that number has dropped down to 32 percent as of March 2016.
In total numbers, these statistics show that about 2 million Hispanics across Texas still do not have medical insurance. The report from the Episcopal Health Foundation and Rice University’s Baker Institute for Public Policy also concluded that about half of the uninsured rate among this population is actually eligible for healthcare coverage under either the Affordable Care Act’s exchanges or through private health plans.
“We estimate 920,000 Hispanics are eligible for coverage now, even without Medicaid expansion or any other widespread change in coverage,” Elena Marks, EHF’s president and CEO and a nonresident health policy fellow at the Baker Institute, said in a public statement. “This report clearly shows the need for outreach and enrollment efforts to continue to focus on Hispanic Texans who are uninsured but eligible for coverage.”
Additionally, the report discovered that approximately 300,000 Hispanics in Texas fall into a coverage gap where they are not eligible for Medicaid or the tax subsidies offered via the ACA health insurance exchanges. Since the state of Texas did not expand Medicaid as encouraged under the Affordable Care Act, there are large sections of the population that are simply unable to afford medical insurance and ineligible for government assistance.
“Unless Texas expands Medicaid or devises an alternative system of coverage, these 300,000 Hispanics will likely remain uninsured,” Marks continued.
The results in the study also compare the one-third of Hispanic Texans without medical insurance to the much lower uninsured rate of Caucasian adults in Texas - 10 percent - without coverage. Nonetheless, the study finds that two times as many Hispanics enrolled in ACA health insurance exchanges as white Americans residing in Texas.
“After three open-enrollment periods of the ACA marketplace, the uninsured rate among Hispanics is still three times that of whites,” Vivian Ho, the Chair in Health Economics at Rice’s Baker Institute and Director of the Institute’s Center for Health and Biosciences, said in the press release. “The disparity between the two groups remains striking. The Hispanic population is growing at a faster rate than the state average, which makes it increasingly important to the entire state that Hispanics gain affordable health insurance coverage.”
However, in today’s complex health coverage system, it is understandable that many consumers have difficulty with understanding their eligibility for government assistance as well as what benefits they can afford through private medical insurance plans. Payers and providers find claims reimbursement more complex in today’s value-based care environment than in past decades.
IDC Health Insights released a new report that outlines why older legacy systems are not sufficient at reimbursement between payers and providers, according to a company press release. Many health payers feel that replacing all reimbursement systems and technologies will likely cause too many problems and would be overly expensive. As such, payers may benefit from consolidating key functionalities as well as utilizing various products from multiple systems.
"Despite vendor evolution, the speed of payer adoption to make this change is slow because the expense of re-deploying this foundation system is daunting and difficult in these days of cost reduction, MLR, and limited premium increases. However, the environmental reasons outlined in our new report point to how replacing these systems is necessary now for long term success," Jeff Rivkin, Research Director of Healthcare Payer IT Strategies at IDC Health Insights, said in a public statement.
Some of the trends that are affecting payer-provider reimbursement in today’s value-based care environment include customer relationship management, global document management, and multiple strategies for reimbursement.
The report from IDC Health Insights offers some tips for payers to incorporate. First, it is useful to transition to value-based reimbursement strategies within the entirety of the claims and billing engine infrastructure.
Among consumers, some of the confusion regarding healthcare costs and medical billing involves deductibles, health plan benefits, and out-of-pocket costs. As found in the report from the Rice University’s Baker Institute for Public Policy, large sects of the population also do not know they are eligible for government assistance when it comes to their healthcare coverage.
Public and private payers will need to work toward improving consumer education and understanding of healthcare coverage options. Only when consumers have a strong grasp of their health plan benefits and out-of-pocket spending will the healthcare reimbursement system be able to operate more efficiently.
Dig Deeper:
Affordable Care Act Brings Greater Health Coverage to Texas
Affordable Care Act Brought 30% Drop for Texas Uninsured Rate
