By: Alicia Pierce | Thursday, January 26, 2023

Tuesday, January 24, we launched our Session Guide for the 88th Legislative Session at the Texas Capitol, including a Food for Thought lunch highlighting our agenda for a healthier Texas.

Why it matters: Health coverage leads to better health outcomes, but Texas remains the state with the highest uninsured rate in the nation. However, rapid growth in the individual market shows that Texans are eager to sign up for coverage when they learn about affordable, accessible options.

TAHP’s agenda focuses on creating increasing affordable coverage and building on the success of Medicaid managed care in the state.

The full guide gives a comprehensive explanation of health insurance issues for the legislative session, the agenda focuses on key, proactive items.

Affordable Coverage Priorities:

• 🛠️ Build more affordable insurance coverage options that avoid overregulation and excessive mandates.
• 🛒 Allow health plans to create market-driven, innovative incentives to reward patients who shop for the best value care.
• 🤝 Reform state laws to legalize value-based care arrangements between health plans and providers.
• 📖 Study the full impact on businesses and families through a new Health Insurance Mandate Advisory Review Center (HIMARC) before approving a new mandate.
• 🙅‍♂️ Avoid new mandates and overregulation that raise the cost of coverage and force employers and families to pay higher prices.
• 💼 Protect ERISA flexibility and oppose any legislative attempts to add costly mandates on self-funded employers.
• 🛡️ Explore opportunities to build on the state’s high-performing individual market without creating disruptions.
• 🔎 Ban anti-competitive health care contract terms, stop abusive facility fees, and give patients a complete price picture with transparency from all health care providers.
• 🏦 Stop private equity-controlled providers from abusing network adequacy laws to increase prices for Texas patients.

Medicaid Managed Care Priorities:

• 👭 Allow managed care plans to permanently assist with eligibility through the Case Assistance Affiliates program.
• 📲 Expand Medicaid texting options to allow Medicaid managed care organizations to easily communicate with families.
• 💯 Transition all remaining services, populations, and processes into managed care.
• 💊 Oppose any further delays to the Medicaid Preferred Drug List (PDL) carve-in.
• 🧠 Cover the full continuum of mental health benefits in Medicaid.
• 👶 Extend postpartum Medicaid coverage to 12 months.
• ☎️ Allow the use of telehealth for service coordination visits and ongoing assessments.
• 🥦 Allow coverage options that address non-medical drivers of health and incentivize managed care investment through existing rate-setting processes.