With more than one in four Texans currently lacking health care insurance and runaway premiums adding daily to that 6.1 million count, relief cannot not come too soon for our overburdened health care system. In addition to providing new economic security to millions of Texas families, the national health reform bill will also bring billions of dollars back to Texas each year through health insurance tax credits for middle class and low-income Texans, and Medicaid coverage for our poorest citizens.

Our state leadership should move promptly and in good faith to facilitate the implementation of health insurance reforms. Texans can look to the establishment of the Children’s Health Insurance Program (CHIP) and our response to Hurricane Ike as recent examples of the excellent performance of which our state government is capable when it has the backing of leadership.

Click here to read the full statement.

Today, illness and disability can lead to financial ruin for a family.  Health reform will make health insurance coverage more secure and affordable even when a family’s income changes, improving economic security and reducing hardships on struggling families.

Cher worked hard to achieve her dream of becoming a dental hygienist.  Even when she was in school and it was hard to afford, she and her husband bought health insurance.  At age 31, Cher was diagnosed with a rare autoimmune disorder that led to kidney failure.  To treat the disease, she had to endure multiple hospitalizations, lab tests, medications, chemotherapy, and lots of doctors visits.

Cher’s insurance company immediately denied claims, insisting that her disorder was a pre-existing condition.  During her 10 months of dialysis, Cher wrangled with her insurer over her denied claims.  Ultimately, a financial coordinator working with Cher to help get her kidney transplant approved, helped her overcome the insurer objections to get the care she needed.  She received a kidney transplant from her brother in 1999 was able to resume work.

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Bruce is a 61-year old, self-employed communications and fundraising consultant.  As he puts it, his body is “falling apart.” He has had several serious health problems including heart attacks and cancer.  He relies on his high risk pool coverage to help him access the doctors and prescription drugs he needs to manage his chronic conditions and stay out of the hospital.

For nearly 30 years he had an individual health insurance policy his parents first bought for him in the 1960s.  In the 1990s, his insurance company refused to renew his policy, he thinks because he’d had a heart attack.  He applied for coverage with other insurance companies and was rejected because of his pre-existing conditions. Considered “uninsurable” by insurance companies, Bruce enrolled in risk pool coverage, the only source of coverage that cannot reject individual applicants in Texas.

Bruce’s risk pool coverage comes at a steep price.  His premiums just to cover himself are $10,000 per year.  By law, premiums in the Texas high risk pool cost twice as much as comparable policy in the private market.

In addition to steep premiums, Bruce pays significant out-of-pocket costs.  His annual deducible is $2,500, and on top of that, he pays out-of-pocket for copays, coinsurance and health care services not covered by the high risk pool, like dental services.  He estimates that he spends about $20,000 a year in out-of-pocket health care costs on top of his $10,000 annual premiums.

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Call Congress TODAY! 1-866-922-4970

If you think Texas and our country need health reform, if you have read our analyses with only an academic eye, and you have not called, written, or emailed your member of Congress yet to tell them so, now is the time for you to take action. This legislation is too important for your elected official not to hear from you directly.

We are on the verge of a monumental advance in access to good, affordable care for Americans, and an opportunity to make this degree of progress may not come around again for another generation. CPPP and TVHR urge you to make that call, send that email or FAX today, and encourage all who you can to do the same. This is your last chance to make a difference in getting health care reform over the finish line.

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Andrea arrived home to an unwelcome surprise. Her insurance company sent her a letter explaining that the doctor who treated her son in the NICU was not a part of the provider network. Despite the urgency of her son’s condition and the fact that she was not given a choice of which doctor would treat her son in the NICU, the insurance provider refused to pay for the bulk of the NICU doctor’s charge of $1,145.

I just couldn’t believe that something like this was allowed to happen in America, we spend close to 25 percent of our gross income on total medical expenses a year, and it’s just getting more and more expensive every year.  At some point people aren’t going to be able to afford it.

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The month after his open heart surgery, Mario applied for Social Security Disability benefits.  Like many workers who become disabled as adults, Mario was certified for both SSI (income related) and SSDI (work history related) disability cash benefits.  His SSI started right away, which automatically qualified him for Medicaid, too.  This Medicaid coverage retroactively took care of his surgery bills.  By federal law, work-related SSDI benefits do not begin until 5 months after you are found eligible.  Very often, a worker’s SSDI benefits—based on their past earnings—are higher than the maximum income allowed for SSI, and this was the case for Mario.  So, when his SSDI cash benefits began, he lost his SSI and Medicaid (health coverage for very low-income citizens).  Then, he began waiting out the federally-required 24-month period before Medicare health coverage for people over age 65 and adults who become disabled) starts for SSDI beneficiaries.  This left Mario uninsured for two more years as he faced high out-of-pocket costs for follow-up care, making it difficult for him to seek regular treatment with a primary care physician.

I have helped a lot of people to navigate the health care system, and I share what I’ve learned.  We have to make our voices heard.  There are people who have savings, who can draw upon an inheritance to defray medical coasts.  But we need health reform for our children, so they can have health insurance.

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Sarah was covered through her father’s job-based insurance.  The plan dropped her in early 2009 because she was 23 and no longer a full-time student.  She did not find out that she’d lost coverage until she went to the pharmacy to pick up a prescription.  While her parents scrambled to get Sarah enrolled in COBRA coverage, she had to pay for three months of medication out-of-pocket as her COBRA enrollment was getting sorted out, totaling around $1,000.  After her COBRA was set up, it took more than six months for the health plan to partially reimburse her for those expenses.  She now pays $300 a month for her COBRA coverage.

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Re-posted with permission from our friends at the North Carolina Justice Center

You’ll hear any number of statistics thrown around about how the public feels about health care. Usually, this is broken down into pro-and anti-reform numbers — who likes the current bill, and who doesn’t.  Chris Fitzsimon went a step further, breaking down poll numbers. Turns out 37 percent of the people who express skepticism about the bill don’t think it goes far enough.
The public wants — indeed, demands — health care.

41—percentage of people who say they “favor the health care reform proposals presently being discussed” (Ipsos/McClatchy Poll. Feb. 26-28, 2010)

47—percentage of people who say they “oppose the health care reform proposals presently being discussed” (Ibid)

37— percentage of those who oppose health care reform proposals presently being discussed because they “favor health care reform overall but think the current proposals don’t go far enough to reform health care” (Ibid)

58—total percentage of people who favor health reform proposals presently being discussed or support reform but think the current proposals don’t go far enough (Ibid)

30—total percentage of people who oppose health care reform proposals presently being discussed or oppose reform but support current proposals because they will keep health reform from happening (Ibid)

57—percentage of people who think that the Republicans are deliberately avoiding compromise in order to obstruct the bill in any form (Ibid)

36—think that Republicans in Congress are working hard to try to find a compromise with the Democrats on the health care bill (Ibid)

67—percentage of people who say they are not confident in pharmaceutical companies to recommend the right thing for reforming the U.S. health care system. (Gallup Poll. March 2-3, 2010)

71—percentage of people who say they are not confident in health insurance companies to recommend the right thing for reforming the U.S. health care system. (Gallup Poll. March 2-3, 2010)

19—-percentage of people who say that Congress should stop working on health care reform this year (Kaiser Family Foundation Tracking Poll, February 23, 2010)

76—percentage of people who say it is extremely or very important to reform the way health insurance works (Ibid)

68—percentage of people who say it is extremely or very important to provide financial help for lower and middle income people as part of health reform law (Ibid)

58—percentage of people who say they will be angry or disappointed if Congress decides to stop work on health care reform and does not pass a law this year (Ibid)

38— percentage of people who say they will be happy or relieved if Congress decides to stop work on health care reform and does not pass a law this year (Ibid)

Health reform isn’t just about expanding health insurance coverage. It also creates jobs and lifts wages, reduces federal deficits, boosts state economies, creates new opportunities for small businesses and entrepreneurs, and bolsters families’ economic security.

Spiraling health care costs are financially crippling employers and families and driving our long-term federal deficit.  Health reform bills are designed to slow the growth in health care costs, which:

• reduces the federal deficit,
• helps shore up Medicare, and
• allows employers to increase wages, hire new employees or make other investments in their business with money that would otherwise be eaten up by skyrocketing health insurance premiums.

Today, access to coverage is unreliable. Insurers can cancel coverage after people get sick, and insurers can deny applicants with pre-existing conditions or impose waiting periods before their care is covered. On top of that, job loss often also means losing health insurance.  Health reform makes health insurance coverage more secure, which:

• reduces bankruptcies caused by medical bills,
• allows entrepreneurs to start new ventures without fear that leaving a current job will mean losing health coverage,
• lets small firms operate without providing health benefits while ensuring that their employees still have access to high-quality affordable coverage, and increases the pool of employees available to small businesses.

To learn more about heaath reform’s economic benefits to small businesses, families, the state economy, and the federal budget, see our new Policy Page Health Reform Will Benefit Texas Small Businesses and State Economy.

The President’s Bi-Partisan Health Reform Summit is tomorrow morning.  Watch it live by tuning in online at www.WhiteHouse.gov/live at 9am CST.

Want to prep for the 2/25 health reform summit with a good update on What’s in the Health Reform Bills—what they will mean for Texas, and what is happening with them in Washington? Have questions you’d like to get answered?

This morning, the CPPP hosted a webinar to answer all your questions. We covered:

•    The latest on the debate and process in Washington
•    The main building blocks for expanding coverage and insurance reform
•    Issues where compromise is still being worked out
•    Immediate reforms and Medicare improvements What YOU can do to affect the debate

The presentation is available on the CPPP site for download, and a recording of the webinar and the follow-up Q&A has been posted as well.