TAHP – Texas Association of Health Plans

New Poll: Texas Voters Support a Strong Medicaid Program

88% of Texas voters say it’s important to have a strong, sustainable Medicaid program according to a new Morning Consult poll. Why it matters: Texas Medicaid provides coverage…

Surprise Billing Rules

What’s New With the No Surprises Act? Final rules for the arbitration process of the No Surprises Act have…

Medicaid Monday: Service Coordinators Connect Members to Services

Today’s Texas Medicaid is more than health care coverage—it connects Texans to the personalized care and support they need to stay healthy and live the fullest lives possible. Medicaid managed care gives Texans with complex medical needs access to caring health plan nurses that provide one-on-one support and walk families through every step of the complicated and overwhelming health care system.

Enhanced ACA Subsidies Mean More Coverage for Texans

Yesterday, President Biden signed broad ranging legislation that includes several major health care initiatives, including extending the enhanced subsidies for ACA health plans. First part of the American Rescue Plan Act, these enhanced subsidies help make coverage affordable for many Americans, but were set to expire at the end of this year. Under the new legislation, the enhanced subsidies will go through 2025.

Medicaid Monday: Managed Care Organizations Partnering with HHSC To Address Eligibility Issues After the Public Health Emergency

As the end of the COVID-19 Public Health Emergency approaches, the Texas Health and Human Services Commission (HHSC) is actively preparing to complete a large number of eligibility and enrollment actions. Beginning as soon as mid-October, an estimated 3.7 million Texans will need to have their Medicaid eligibility redetermined. For those individuals who found themselves needing Medicaid for the first time during the pandemic, this will be their first experience with the redetermination process.

Value of Coverage: Healthy Communities

Health plans focus not just on the health of individual members, they also invest in the health of communities. By helping to build strong communities, health plans support better health outcomes for everyone. Since the beginning stages of the pandemic, Superior HealthPlan has worked with more than 70 schools and organizations in Texas to launch and fund hygiene closets for lower-income neighborhoods. Grants to the community-based organizations hosting the closets help organizations meet people’s basic needs and create community connection.

Medicaid Monday: Mental Health Innovations in Managed Care

In 2021, 34.2% of adults in Texas reported symptoms of anxiety and/or depression. Experiencing mental health challenges can have long-lasting consequences, especially for vulnerable populations. Every Texan deserves access to mental health services. Today’s Texas Medicaid managed care organizations provide a broad spectrum of screenings and treatment services for mental health conditions and substance use disorders with timely access for members and appropriate follow-up care. Managed care allows for flexibility in developing new models of service delivery that are not possible in traditional fee-for-service.

Value of Coverage: Mental Health

People with health insurance have better access to care, and importantly that includes mental health care. Two recent studies show that people with insurance not only have better access to mental health services, but they are overwhelmingly satisfied with the services they receive.

Medicaid Monday: Managed Care Means Innovation

In Texas, the 1115 Medicaid Transformation Waiver allows the state to expand managed care, which allows for innovations not permitted in traditional fee-for-service Medicaid. Since the inception of managed care, ensuring high-quality care for members has been the work of managed care organizations. Here are some ways Texas managed care health plans go beyond the walls of a doctor’s office to increase community access to services, reduce unnecessary hospitalizations, and improve the quality of members’ lives.

Now is the time for Texas to look for ways to reduce Big Pharma’s big prices

At $15.3 billion annually, Texans spend more on prescription drugs than any other state in the country. Big Pharma continues to raise prices, making lots of prescription drugs unaffordable. During the COVID pandemic alone, Big Pharma raised prices on 832 drugs. Patients are taking to Twitter to express outrage and shock at the rising price of the sometimes life-saving medicine they need.