Allowing Texas state employees and retirees the option of choosing a Health Savings Account (HSA) plan is a solution proven to lower costs without impacting quality or access to health care.
March 31, 2010
Testimony to the Senate State Affairs Committee Relating to the actuarial and financial conditions of health care programs administered by the Employees Retirement System By Elizabeth Young
Given the growing burden on taxpayers, the state should consider giving state employees and retirees the option of choosing a Health Savings Account (HSA) plan.
The 2nd installment in the Liberty Lecture Series are remarks made by U.S. Congressman Paul Ryan (R-WI) about the real cost of health care at President Obama's health care summit in February.
To be successful, reforming the nation’s health care system must be patient-centered, not government-centered. That’s why our elected officials should consider alternatives to expanding the already massive state-federal Medicaid program.
Some American policymakers want to emulate the nationalized health care systems that currently exist in other countries. This paper examines nationalized health care systems to determine whether universal coverage actually translates into better health care outcomes for participants in such a system.
This Texas-specific shapshot highlights key facts from Dr. Arthur Laffer's new report, "The Prognosis for National Health Insurance: A Texas Perspective."
The health care reform plans pending in the U.S. Congress would cause more harm than good—weakening the Texas economy and increasing health care costs on Texas families. The path to true health care reform is through patient-centered solutions, which emphasize the patient-doctor relationship, allowing patients and doctors to make more effective and economical health care choices.
August 04, 2009
Key Fact Sheet From "The Prognosis for National Health Insurance" By Texas Public Policy Foundation
This document highlights key facts from Dr. Arthur Laffer's new report, "The Prognosis for National Health Insurance."
An effective approach to reforming the health care system begins by addressing the incentives driving the
unsustainable rise in health care expenditures. Reforms based on President Obama’s priorities fail to do this. Rather than expanding the role of government in the health care market, Congress should implement a patient-centered approach to health care reform.
By incorporating free market principles to make private insurance more affordable and pushing government programs toward efficient models of care rather than insurance, Texas can lead the way in hitting the right target—a healthy state with a healthy economy.
Both government-run and patient-driven health care concepts have been tried before, but not all aspects of these plans are easy to understand. This paper draws from multiple sources to educate the public about the current health care reform options from a national perspective.
July 21, 2009
Prescription for a Cure A Patient-Centered Approach to Fixing America's Health Care System By Texas Public Policy Foundation
Within the health care debate, there are striking differences in the solutions proposed by the various participants in addressing access, cost, and quality. Proposals gaining momentum in Washington D.C. advocate for government control of health care, but the only reforms proven to be successful are patient-centered.
A review of the 81st Texas Legislature’s work on the Children's Health Insurance Program (CHIP), Medicaid, private health insurance, and health care regulations.
The creation of an optional HSA plan will create competition among health plans and provide state employees with more choices and a more affordable monthly option.
The federal government’s move to provide TANF funds as a block grant to states has allowed Texas to spread its TANF funds in a fiscally responsible way across a number of programs and state agencies.
Considering Texas’ growing need for lower cost alternatives in health care, policymakers should look for every opportunity to give Texans a diversified provider field that offers a variety of health care options at a range of prices. Easing regulations on nurse practitioners would give consumers more choices and more affordable options.
The cost of providing health benefits to Texas’ state employees has been climbing for years. In an effort to control mounting costs, the Legislature should readjust cost sharing for state employees and offer the option of a high deductible health plan and health savings account to control cost and allow employees to share in the premium savings.
As a result of welfare reform and the emphasis on work, Texas has been a leader among the states for moving people off welfare and into the workplace. A July 2006 USA Today article shows the number of families receiving welfare in Texas declined by 68 percent between August 1996 and December 2005.
Congress established the Children’s Health Insurance Program (CHIP) in 1997, in response to mounting pressure to address the number of uninsured children in the United States. Proponents of the plan argued that CHIP would deliver health insurance coverage to half of the nation’s 10 million uninsured children by 2000. Through federal FY 2005, however, the CHIP program had never reached enrollment of even 4 million children at any given time.
Consumer-driven health care has become a popular term with the creation and wide spread adoption of personal health accounts, such as Flexible Spending Accounts (FSAs), Health Reimbursement Arrangements (HRAs), and Health Savings Accounts (HSAs). However, as the popularity of these accounts has grown, so have issues that impact the ability of individuals to make decisions about their health care.
Health insurance mandates ultimately harm consumers by making health insurance more expensive and requiring individuals to buy health benefits that they would not choose if they had the option. Additionally, they limit the opportunity for insurers to develop new and innovative products tailored to the individual.
November 14, 2008
Medicaid 2009-2010 Legislators' Guide to the Issues By Kalese Hammonds
Since Medicaid was established by Congress in 1965, and in Texas in 1967, more than four decades of incremental policy expansion has created the largest government health program, providing benefits to more people and at a higher cost than even the Medicare program.
Mandating student health insurance would do little to actually reduce the rate of uninsured young adults and would add extra cost to the already high and rising cost of higher education, making higher education unaffordable to more Texans.
As the cost of health care in Texas rises, the prohibition on the corporate practice of medicine has become a hotly contested topic, raising questions about whether physician employment compromises a physicians’ ability to make medical decisions in the best interest of their patients.
As we gear up for another legislative session the rallying cry to “insure the uninsured” becomes louder and louder, but should crafting additional insurance programs be the focus of public policy?
The cost of health care is expensive enough, but burdensome Texas hospital regulations drive up the operating cost of hospitals and increase the price patients pay for health care.
Real change for our health care system means addressing the rising cost of health care and making it more accessible by taking actions to lower costs without incurring more government expenses or increasing the burden to taxpayers. The most effective way to do that is with a healthy dose of competition and free market forces.
With almost 560 state employees per 10,000 Texas residents, the increasing cost of health insurance benefits means state lawmakers must allocate considerable funding for these benefits. While health insurance benefits are an appropriate benefit for state employees, there are things lawmakers can do to help control these costs.
Massachusetts’ health care reform promised to provide universal health care coverage for the entire state and reduce health care costs, but two years after its implementation, it has accomplished neither. Not only has the program failed to insure the entire population, but it is running hundreds of millions of dollars over budget.
Specialty hospitals create a competitive environment that leads to higher quality health care and expanded consumer choice. However, prohibitive government regulations threaten these innovative facilities—ultimately threatening choice, affordability, and improved quality for all health care consumers.
Texas has the opportunity to lead the way in creating a more competitive health insurance market while giving Texas consumers more health insurance options. Ultimately, more competition will give Texans more choices in both benefits and prices.
February 21, 2008
Individual or Group Coverage? Regulating Health Reimbursement Arrangements in Texas By Kalese Hammonds and Mary Katherine Stout
For many small group employers priced out of the insurance market, Health Reimbursement Arrangements offer an affordable alternative to traditional health insurance. Unfortunately, current regulations prevent HRAs from being used to their full potential.
February 20, 2008
2008-09 Budget Snapshot Texas Medicaid and the State Children's Health Insurance Program By Mary Katherine Stout
Public health care makes up a huge portion of the Texas budget. This brief provides a snapshot of just how much of the state’s budget is spent on health care.
In comparison to other states, Texas nurse practitioners are among the most highly regulated in the country. Given the need for lower cost alternatives in health care, it is essential that policymakers look for opportunities to ease regulations on nurse practitioners in order to offer more choices and affordable options for patients.
If the U.S. Congress increases federal cigarette taxes and faces long-term declines in the sale of cigarettes as a result of the increases, so too will Texas face declining state tax revenue.
This presentation given at the American Legislative Exchange Council's meeting in July 2007 answers key questions about SCHIP reauthorization and offers better solutions to improve the program during reauthorization.
A review of the 80th Texas Legislature’s work on the Children's Health Insurance Program (CHIP), Medicaid, Health Savings Accounts (HSAs), health care mandates, and deregulation.
May 08, 2007
Survey of State Employee Benefits Comparing Traditional Health Benefits & Health Savings Accounts in the States By Mary Katherine Stout
As the Texas Legislature considers giving state employees an HSA option, at least 10 other states have already given their state employees this chance. As each of these states demonstrates, the plan design and savings for both the state employees and the state can vary.
While HSAs are an important step in reforming state employee benefits and offer state employees more choice and significant savings, persistent myths misrepresent how HSAs work and their effect on state employee benefits. State employees and legislators need the facts.
This brief examines the issue of the uninsured, providing recommendations on how states should be looking not only to ensure a robust and competitive private marketplace for health insurance, but for opportunities to create a bridge between public programs and private coverage.
Since the Texas Legislature passed a series of reforms to the Children’s Health Insurance Program (CHIP) in 2003, a strong contingent of legislators, advocacy organizations, and special interests has lobbied to reverse these essential reforms.
As the Legislature prepares to meet in 2007, it is likely that state employee health insurance will again require new money to keep pace with current benefit levels and increased costs. This growth is within the state's control if it introduces consumer-driven health care models, sharing both cost and savings with state employees.
Mary Katherine Stout, director of the Center for Health Care Policy at the Texas Public Policy Foundation, presented testimony before the Texas House Appropriations Subcommittee on Health and Human Services regarding Medicaid reform, October 9, 2006.
Mary Katherine Stout, director of the Center for Health Care Policy at the Texas Public Policy Foundation, presented testimony before the Texas Senate Committee on Health and Human Services regarding Medicaid reform, September 19, 2006.
Texas has successfully met many of the goals of welfare reform, yet work remains to be done. To meet new federal laws, Texas must continue to strengthen the relationship between welfare and work by more fully engaging TANF recipients in work activities.
Today's health care system needs a strong dose of consumerism and market competition-- resulting in a more sensible, visible pricing structure for patients.
Before expanding government programs to address the issue of the uninsured, policy makers must take a closer look at the data to identify the real reasons -- and provide effective solutions -- to reduce the number of uninsured.
April 27, 2006
Pocket Facts Children's Health Insurance Program in Texas By Mary Katherine Stout
This report looks at the design of the CHIP program, whether CHIP is meeting the goal of covering uninsured children, and the impact of policy changes coupled with an improving economy as they relate to the decline in CHIP enrollment.
This comprehensive report puts growth in spending and caseload in context with policy changes at the federal and state levels over the life of the Medicaid program.
March 28, 2006
Pocket Facts Medicaid: Yesterday, Today, and Tomorrow By Mary Katherine Stout
Facts and recommendations taken from "Medicaid: Yesterday, Today, and Tomorrow" by Mary Katherine Stout, director of the Center for Health Care Policy Studies.
There is no question that the rising cost of health care, and the cost of prescription drugs are creating a hardship for many Texans. But is importing pharmaceuticals from Canada really the best solution? This perspective explores the Canadian prescription drug system, and the myths surrounding drug importation in the context of legislation passed in the 79th Session.
May 16, 2005
Price Transparency Giving Control to Health Care Consumers By Mary Katherine Stout
One of the biggest problems facing the health care system
today is the emphasis on third party payment, which insulates
the individual from the price of health care services
and from important and personal health care decisions.
Ensuring that health care prices are transparent encourages consumers to make more informed decisions, with greater sensitivity to price.
Mandates are no doubt well intentioned, but the unintended consequences are significant.
Mandates make health insurance and health care more expensive. The more expensive, the
harder it is for business and individuals to afford. The more difficult to afford, the more
businesses drop health insurance coverage and individuals decide to forego coverage, causing
the rate of uninsured to rise.
March 30, 2005
Health Savings Accounts Affordable, Portable, and Accessible Health Insurance By Mary Katherine Stout
Health Savings Accounts offer employers and individuals an affordable new option for health insurance coverage. Health Savings Accounts (HSAs) have grown in popularity since Congress authorized their use in 2003. The forerunner to HSAs, Medical Savings Accounts (MSAs), were first established in 1996 and had extensive restrictions that impeded their use and success. HSAs are free of those restrictions, and anyone can own one.
The costs of inmate health care are enormous. The state estimates that it costs over $500 a day to keep a prisoner in the hospital and the prison hospital at the University of Texas Medical Branch at Galveston recently announced they will run out of money in a matter of months. County jails face these same skyrocketing health care costs.
In recent years, Texas Medicaid spending has doubled, on the average, every six to seven years, an eightfold increase in less than 20 years. At this explosive rate of unprecedented growth, the present $17 billion annual Texas Medicaid budget will exceed $136 billion annually — more than one-quarter of a trillion dollars ($272 billion) a biennium in less than 20 years. That amount is more than double the state’s budget today.
For most Americans, purchasing health care services is unlike the buying experiences in other areas of our lives. We pay very little — only about 15 percent — of our health care costs, and generous “all you can eat buffet” insurance plans give us a strong incentive to maximize payouts from insurance providers. But not only are such plans good for individuals, they should be carefully considered as a way to improve the care and reduce costs for Medicaid beneficiaries and government employees.
Text of prepared remarks by the Foundation's director of research, who was invited to address the Senate Health and Human Services Committee on the issue of Medicaid.
September 21, 2004
Pocket Facts Medicaid And the Uninsured By Texas Public Policy Foundation
Facts and recommendations taken from "Medicaid And The Uninsured" by Beau Egert.
Medicaid continues to drive state budgets across the country. Texas is no exception. Without reform, Medicaid threatens to consume an ever increasing share of the state budget, potentially jeopardizing every other important service. While spending on Medicaid has risen sharply – many argue drastically – Texas has remained at the very bottom of the rankings nationally in terms of the uninsured. Policymakers in Texas must take action both to contain Medicaid spending and decrease the number of uninsured. In addition to recommending changes to the Medicaid program, the report calls for incentives to encourage small businesses to provide health insurance plans to employees.
Presented before the House Select Committee on State Health Care Expenditures, this is an outline of the testimony offered by the Foundation's director of research on the issue of government-subsidized insurance (in this case, the Children's Health Insurance Program) competing with private sector coverage.
The purpose of this report is to explore ways to reduce expenditures for the public school employee health insurance program. The question is whether the $1 billion dollar per year program is a bane in adding to the depth of the budget deficit or a boon in providing clues to reduce expenditures for all of the state’s health insurance programs costing over $10 billion per year.
How can Texas reduce expenditures for the new public school employee health program while protecting and improving benefits? The Texas 78th Legislature faces this key question as members confront a $9.9 billion revenue shortfall. The health care program is targeted for legislative cuts. Funded for its first year only, the program was financed by revenues taken from a “one time” source; additional blows were delivered by a sagging state economy and rising insurance costs, estimated in the range of $2.5 billion for the 2004-2005 fiscal year.
Health care is heading for the “perfect storm.” The confluence of skyrocketing health-care costs and a slowing economy threatens to destroy the quality and accessibility of health care for all Texans.
If your child was critically ill, you'd demand the best medical treatment possible. You'd call not only for the best doctors, but for the best medical technology. After all, a simple kink in the tubing that provides medicine, nutrition, oxygen, and water to your child could prove deadly.
Texas should adopt the defined contribution reform plan that offers state and local government workers the choice of a defined contribution retirement plan in place of their current defined benefit plans. Such a plan offers great advantages for both workers and taxpayers. Over the past 20 years, private sector employers have shifted sharply towards “defined contribution” pension programs. The number of private sector employees in such plans soared from 11 million in 1975 to 43 million in 1995, an increase of about 300%.
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