by Ramiro Cavazos
San Antonio’s economy is built on a foundation of more than 40,000 small businesses, made up of people who build our homes, serve our meals, schedule our dental appointments and are active consumers in our economy. They are our relatives, our neighbors and our friends, people we interact with every day. Many of them cannot afford health insurance. This is crippling for families and our local economic vibrancy.
Roughly one in five people in Bexar County lack health insurance. Many work for small employers that can’t or don’t offer health insurance. Existing federal and state Medicaid rules don’t provide a coverage option for low-wage working Texans. More than a million Texans are stuck in this coverage gap, making too much under state rules and too little to qualify for the federal subsidies to buy health insurance through the Healthcare Marketplace. When they get sick, they have few options other than expensive hospital emergency rooms. The cost of providing care for these uninsured workers is passed on to those with health insurance ($1,800 a year in higher premiums per person) and results in higher property taxes, lost productivity and lost wages that would have paid for local goods and services.
Texas has the largest population of uninsured individuals of any state in the country. The state’s six million uninsured individuals represent 24 percent of the state’s population and include 1.2 million children and 3.3 million Latinos. At the same time, Texas has some of the nation’s highest rates of childhood obesity and chronic diseases. These folks are often referred as “falling in the gap.”
While Texas has not expanded Medicaid as 28 states have done and others are considering, there is another option, called the Texas Way Program, supported by a coalition of health care organizations and businesses. It is a private-market-based coverage solution using available federal funds — money we send to Washington, D.C., through the income tax we pay — to cover persons in the coverage gap. The plan is built on Texas values, requiring personal responsibility through cost-sharing. It includes incentives for people to work and make healthy decisions. It also includes higher co-pays for emergency room visits for non-emergency care.
Many local small business owners want to offer affordable coverage to their workers but are unable to because of cost. They know that insurance coverage would reduce absenteeism, boost productivity and reduce their property taxes. The Texas Way Program would provide subsidies to employees of small businesses to purchase health insurance and it would protect our Texas small business owners from incurring almost $400 million in unnecessary federal penalties for not providing coverage under the Affordable Care Act to their employees.
The Texas Way Program is the fiscally responsible, value-based approach to reducing the number of uninsured without adding to the state’s Medicaid rolls. Similar programs already have been approved in Arkansas, Iowa, Indiana, Pennsylvania, Michigan and New Hampshire. The Centers for Medicare and Medicaid Services (CMS) has said it is willing to work with Texas to develop the Texas Way Program as an alternative to traditional Medicaid expansion.
Expanding access to health care for those who fall in the gap creates robust communities, allows for opportunities to reduce mortality rates and provides job growth. Let’s take a step in the right direction and expand access to care for more Texans. It’s the right thing to do to move Texas forward.
The San Antonio Hispanic Chamber of Commerce prides itself on contributing to state and national conversations on health-care policy and champions the Texas Way Program to increase economic prosperity and access to health for all Americans and Texans.
Ramiro A. Cavazos is president and CEO of the San Antonio Hispanic Chamber of Commerce.
Source: San Antonio Express News (Print Edition)