Texas State government has decided not to implement the health insurance exchange that’s mandated federal law. Republican Governor Rick Perry strongly opposed the Affordable Care Act and threatened to reject any law pertaining to the implementation of a Texas health insurance exchange.According to Rep. John Zerwas, MD, who sponsored the bill to create the Texas exchange, Gov. Perry is emphasizing that he does not want to be involved in the execution of health care reform in any possible way.In contrast, the Texas Medical Association supports the Zerwas bill. Special grants would be offered to those with earnings at 400-percent of the federal poverty line to help them buy coverage through the exchange.By January 2013, the Department of Health and Human Services will screen health insurance exchanges that have been created by different states. If these are deemed fit to operate in accordance with the health care reform law by 2014, states will retain control. If not, the federal government will step in to fulfill health care reform.Steve Larsen, director of the HHS Center for Consumer Information and Insurance Oversight, says that states who fail to enact their own exchange will have a second chance. They need to submit notice 12 months in advance, though.What Is The Texas Health Insurance Exchange Alternative?Gov. Perry approved a bill to create “health care collaboratives.” Under this bill, health care organizations that take on the financial risk for treating consumers will be categorized as TX health insurance. Physicians will be given the opportunity to participate in more than one of these collaboratives.Another alternative has been making news, too. In Camden, New Jersey, which is infamous as one of the poorest and most violent cities in the nation, an innovative idea has cut the cost of healthcare by 40 to 50 percent.An official from the Obama administration and two members of Congress have already visited the city to some the new strategies. One idea is to bring health care to those who need it most. Two hotspots showed up as epicenters for the biggest medical bills. One of those areas was an apartment building for 300 disabled or elderly people. The reason why health care was so costly here was not the sheer volume, but that expensive emergency care was being substitutes for preventive care. They turned the cost of health care upside down here by adding a nurse practitioner’s office in the building.Having regular preventive care check-ups not only saved money, but also improved the quality of life for many of the apartment’s residents because they received better care than what was available via the E.R.Will A Texas Health Insurance Exchange Improve Preventive Health Care?The health insurance exchange also stands to move people who couldn’t previously afford TX health insurance out of the E.R. When more people have access to preventive health care, we may see a reduction in medical expense throughout most large cities.If one of the poorest cities in the nation can cut medical costs by 40 to 50 percent while improving the quality of health care and reducing the need for health care, what stands in the way for other cities? Could it be that those who profit from high-priced emergency room care are holding us back?
With health care costs soaring through the roof, the cost of health insurance premiums are increasing as well. Health insurance is a necessity, however, when you consider the costs of one visit to the emergency room, surgery to set a broken bone, scans, lab and other costs. When your budget is limited, how can you keep the costs of your health insurance premiums down? There are several steps you can take to reduce your health insurance costs and still maintain adequate medical coverage when you need it.First step is to consider what health insurance options you have. Does your employer offer a group medical benefit? Many employers (and/or labor unions) offer health benefits to full-time employees. Group health insurance is usually the cheapest way to get medical coverage; an employer can negotiate with health insurance companies to get a group health plan at cheaper rates. In addition, many employers will pay part of the premium, reducing your health insurance cost even further. Another consideration is whether your spouse has health coverage available through their employer? If so, compare your health benefits plan to that of your spouse, and decide which health plan is the better buy. It may be possible to have one spouse carry family health insurance coverage and the other drop their health benefits. Many employers have multiple health insurance options, so review these plans as well. Choose the health plan that best meets your needs at the cheapest rate.If no health insurance coverage is available through your employer, there are other ways to obtain health insurance coverage. Individual and family private health insurance policies are available. Shop and compare benefits and premiums from each health insurance plan. If you and your family are generally healthy, the new Health Savings Account (HSA) may be worth consideration. The HSA is an account that allows you to save tax-free dollars for your medical/health expenses. Similar to an Individual Retirement Account (IRA), you are limited in the amount that you are allowed to contribute each year; however, with the HSA, withdrawals for health expenses are not penalized, and no tax is paid on the withdrawal. When paired with a health insurance policy that has high deductibles and low rates, the HSA may be ideal for you. Save money in the HSA for deductibles and co-pays, and you’re set.For those over 65 or permanently disabled, Medicare is available through the federal government. The original Medicare is an 80/20 plan (they pay 80% of eligible expenses and the insured pays 20%) with an annual deductible and a monthly premium. Supplemental health plans are available to cover this deductible and co-pay. These supplemental health plans are usually private and the insured pays a premium. In addition to the original Medicare plan, there are Medicare HMOs. In these Medicare HMO health plans, the Medicare premium is paid to an HMO to provide benefits to the insured. HMO plans are more restrictive in that patients must get care through a network provider, but often these plans cover more prescription drugs and preventive care than original Medicare does.Recently some employers have offered lower premiums to employees who do not smoke cigarettes. This is currently a controversial topic for some, but it certainly may begin a trend. In the future, employers and their health insurance providers could offer reduced premiums for employees who maintain normal weight, exercise regularly, and receive certain wellness benefits. Maintaining a healthy lifestyle lowers the risk to the health insurance company that they will be paying big bucks in health care down the road. And health insurance, as any other insurance, is all about risk.Bottom line: going without health insurance coverage is a big risk for you. Find health coverage that you can afford just in case Murphy comes knocking at your door!