TDI
The Sunset Commission Makes Recommendations on TDI and OPIC
The Sunset Advisory Commission met Wednesday, September 24, to make recommendations on Sunset issues for the Texas Department of Insurance (TDI) and the Office of Public Insurance Counsel (OPIC). The Commission considered the Sunset staff recommendations (released in May), the public testimony on those recommendations in June, and public comments.
Health care reforms in the past three sessions have primarily focused on public programs like CHIP and Medicaid. The decennial Sunset Review of TDI offers a unique opportunity for lawmakers to focus on health insurance reforms in the private market. (Click here the most recent Texas uninsured statistics) Texas Impact is disappointed that the Sunset Commission punted its current opportunity to strengthen the health insurance market. However, it is clear that the preliminary discussion around the sunset review process has elevated health insurance issues to be addressed in the House and Senate in the 81st Session.
Texas Impact, along with a coalition of other public interest groups, supported three key changes to the Sunset Staff report: Strengthen TDI’s rate oversight authority, prioritize consumer protections by redrafting the mission statement of TDI and strengthening the role of OPIC, focus on health insurance solutions through the development of a health innovations center within TDI. (Further explanation of these recommendations can be found in our report “A New Diagnosis”)
Representative McClendon offered two proposals to the commission. The first addressed a concern that the agencies mission statement does not express a clear responsibility to protect and serve consumers. The second proposal addressed making health insurance a priority by developing a center within TDI to focus on health insurance solutions. The Commission did not vote to include these items in the sunset bill but agreed to draft a letter commending the proposals to the chairs of relevant legislative committees. Senator Deuell proposed recommendations to strengthen health insurance rate regulation. The Commission voted not to include the recommendations in the sunset bill, but members agreed that a full discussion of rate regulation should occur on the House and Senate floor during session. Senator Deuell said he would file his recommendations as bills. The recommendation by the Sunset Staff to abolish OPIC was overturned by a unanimous vote from the Commission.
What Happens Next:
Now that the Sunset Commission has made its final recommendations on TDI and OPIC to the Sunset Staff, the Sunset Staff and Legislative Council will work together to draft the Commissions recommendations into an “introduce version” of the bill. As two separate government agencies there will be a separate sunset bill for both TDI and OPIC. However, since their agency functions are inherently linked they will likely be sponsored together. All sunset bills must be presented to the House and Senate. The Chair and Vice-Chair of the Commission will work with legislative leadership to identify a legislator from both the House and the Senate to sponsor the bill. When sponsors have been identified, the Sunset Staff will partner with the sponsors to carry the bill through the remainder of the legislative process. Legislative leadership will likely commend the bill to the Insurance Committee in the House and the Government Organization, Business and Commerce, or Health Services Committees in the Senate. By the time the bill comes out of committee, amended, and eventually passed, the House and Senate versions are likely to be different resulting in the bill going to conference until receiving approval from both bodies.
What You Can Do:
Schedule a Visit with your Legislators- It is very important that legislators go into the 81st Session knowing that health care and health insurance are an important concern of their constituents.
Host a Screening and discussion of the PBS Film “Critical Condition” at your home, church, synagogue, or temple
Sign the Cover Texas Now Post Card and encourage your friends and family to sign. Packages of post cards and educational materials for you to hand out to others or bring to your group are available at no cost.
Share your Story- Fill out our online story collection form so we can share your story with legislators and their staff. (coming soon)
Testify- While the bill is in committee it will be open to public testimony. Call us to find out how.
Write a letter to the Editor of your local newspaper.
Vote!
Advocates Call for Strong Action in TDI Sunset Review
A broad coalition including consumers, physicians, religious institutions, seniors, patients, homeowners, labor, and others united in a press conference on Tuesday behind an agenda designed to create a healthy insurance market which strengthens protections for patients, homeowners, and drivers while ensuring stability for the industry. The press conference preceded the Texas Sunset Commission's public hearing on the Texas Department of Insurance.
Watch the Press Conference (requires QuickTime Media Player--Download QuickTime Player for free )
The Texas Sunset Commission hearing was designed to gather public input into ways to improve the efficiency and effectiveness of the Texas Department of Insurance and the Office of Public Insurance Counsel as part of the Commission's year-long review process that will culminate in one or more bills in the 2009 legislative session.
"When it comes to insurance, we're leading the nation in all the wrong categories. This is the right time to strengthen insurance regulation in Texas, not weaken it. We stand united today in our resolve to make this happen,” said AARP Texas State Director Bob Jackson. “We've talked about the problem far too long. Our citizens are suffering and are having a tough time finding health, home and auto insurance they can afford. We need real insurance reform now."
The coalition includes groups with an interest in various lines of insurance with various constituencies, including consumers, physicians, religious institutions, seniors, patients, homeowners, labor, and others.
The group’s plan involves strengthening TDI’s mission, enacting real rate oversight, and strengthening OPIC.
A New Diagnosis: Building the Private Market to Improve Health Coverage for Texans
“A New Diagnosis” Focuses on Private Health Insurance Market Reform
Texas Impact today released a study calling for extensive and long-overdue reforms in the private health insurance market in Texas. The report, “A New Diagnosis: Building the Private Market to Improve Health Coverage for Texans,” is released in anticipation of a Sunset Commission hearing on continuation of the Texas Department of Insurance scheduled for Tuesday in Austin.
The report notes that the rate of uninsured Texans is a national scandal, with over 5.5 million Texans without access to health care—25 percent of Texans are uninsured compared to 16 percent of Americans.
Eighty percent of uninsured Texans live in households with at least one working person. While past efforts to improve health coverage have focused on public programs like Medicaid and CHIP, the main source of the discrepancy between Texas and the US is Texas’ poor rate of private insurance coverage. The percentage of Texans covered by the private health insurance market (employer-sponsored coverage or individually-purchased policies) is six points below the national average. If Texas’ private market coverage rate rose to the national average, the report concludes, an additional one million Texans would have health insurance–and without costly investment of taxpayer dollars.
“For years we’ve worked to strengthen programs like Medicaid and CHIP that serve the most vulnerable Texans. But the private market is the appropriate venue for most Texans to obtain health insurance,” said Bee Moorhead, Texas Impact’s executive director. “In 21st century Texas, health insurance isn’t an optional commodity, it’s a necessity—both for individual health consumers and for the sustainability of the state’s health care infrastructure.”
The report makes several recommendations, including:
- strengthening TDI oversight of health insurance rates;
- a premium tax credit for insurer participation in pooling arrangement like small-employer health benefit cooperatives, a high-risk pool for individuals, and a reinsurance pool;
- narrowing Texas’ overly-broad “rate band” pricing system which causes wide disparities in health insurance costs for similar groups with no accountability to consumers for price swings; and
- establishing a new Center in TDI to work with insurers and consumers on market innovations to expand access to private insurance
“We don’t expect the private health insurance market to be perfect—but Texas should come closer to national norms,” Moorhead continued. “When one out of every four potential health insurance customers here can’t get served, it’s time to try some new strategies.”
The report’s principal author is former State Board of Insurance member Deece Eckstein.
Texas Impact's Comments on the Sunset Staff Report on TDI
Following are the comments Texas Impact submitted in response to the Sunset Commission staff's report on the Texas Department of Insurance and the Office of Public Insurance Counsel.
The formal public comment period on the staff report ended June 9, although members of the public are encouraged to provide comments and suggestions throughout the Sunset process. The public hearing on the Texas Department of Insurance will be held June 24 in Austin in the House Appropriations Committee Room (E1.030) in the Capitol Extension.
Texas Impact appreciates the opportunity to comment on the Texas Department of Insurance (TDI) and Office of Public Insurance Council (OPIC) Sunset Staff Report. We had the opportunity to meet with Sunset staff during their review process, and we appreciate the time the staff took to gather information and perspectives from a variety of sources.
As an interfaith organization advancing a religiously based concern for justice, Texas Impact is most interested in TDI’s regulation of health insurance. While we realize that the overarching problem of lack of health insurance is beyond the scope of the Sunset staff’s report, we wish that the report had given more consideration to the role TDI’s structure and mission could play in generating possibilities for new and creative approaches to improving the private health insurance market in Texas.
Improving the private insurance market would not by itself lead to universal health insurance in Texas, but it would help. Currently, more than 5.5 million Texans lack health insurance and less than 50 percent of Texans have employer-sponsored insurance. If Texas simply rose to the national average for employer-sponsored coverage, one million additional Texans would be insured–about 20 percent of our current uninsured population.
We believe TDI’s minimal involvement in health insurance contributes to a public perception that the state’s social service agencies are the “go-to” agencies for individuals needing health insurance. We submit it would be preferable if most Texans could expect to obtain health insurance through the private market and could rely on TDI to provide the information and guidance they need to navigate the market successfully.
TDI’s self-evaluation report includes a recommendation that the Legislature establish a new health insurance division within the agency. Such a division could provide information to individuals and small businesses, and could work with the Legislature and insurers to develop programs that would help meet the health insurance needs of the millions of Texans (and their employers) who want to purchase health insurance, can afford to pay a reasonable premium, but face any of a number of roadblocks that either leave them uninsured or funnel them into a publicly funded program. Although Sunset staff did not pick up on the recommendation to create a new health insurance division at TDI, we believe it reflects practicality and innovation on the part of TDI staff and we encourage the Commission to give it favorable consideration.
We also encourage the Commission to amend TDI’s mission to reflect more balance between consumer interests and the need to maintain a “level playing field” for the insurance industry. Texas Impact has researched the mission statements of many other state insurance regulatory agencies and we find that a number of other states articulate insurance agency missions that include consumer protection. Texas Impact suggests the following as a starting point for an improved mission statement for TDI:
The mission of the Texas Department of Insurance is to maintain healthy insurance markets in Texas by protecting and assisting consumers, providing fair but vigilant regulation, and promoting a stable and competitive environment for insurers.
Texas Impact disagrees with the Sunset staff recommendation to fold OPIC into TDI, but we agree with the Sunset staff that any decisions about OPIC need to be made in the context of decisions about insurance regulatory policy. Regardless of the eventual disposition of OPIC, Texas Impact sees a need for a clear distinction between the provision of information and assistance to prospective insurance consumers on the one hand, and advocacy for consumers in conflicts involving the insurance industry on the other.
Again, thank you for your work and for the opportunity to participate in Texas’ unique and vibrant Sunset review process.
Coalition Says State Agency Report Ignores Health Insurance Crisis
AUSTIN--A coalition of religious and consumer groups said it’s alarming that a key state government report on insurance released this week barely mentioned Texas’ ailing health insurance market. Advocates said that the Sunset Commission staff evaluation of the Texas Department of Insurance released Wednesday, May 21, gives the Legislature little guidance to address one of the most serious problems facing Texans.
“Health insurance got stiffed in this review, even though it’s the one kind of insurance that every single Texan needs. A market that fails to serve one out of every four prospective customers is clearly in need of strong legislative and regulatory direction. Legislators should make sure that TDI exists to make insurance available and affordable for taxpayers, not just to maintain a playing field for the insurance industry,” said Bee Moorhead, director of the interfaith group Texas Impact.
Stacey Pogue of the Center for Public Policy Priorities said legislators should adopt health insurance regulatory strategies that have helped other states keep more people insured. “Other states have better insured rates than Texas not because they have bigger public welfare programs, but because their residents have better access to private insurance. If legislators want private insurance to be the norm for Texans like it is in other states, they should look at a combination of sensible market regulation and targeted programs to increase access to coverage that have made affordable insurance available to more people in other states.” Pogue said.
In a report issued earlier this year, the Robert Wood Johnson Foundation said Texans saw health insurance premiums jump 40 percent in five years. That's 10 times faster than the increase in Texas income. Texans have the third-highest premiums in the nation. Experts said that is because the state has the highest number of uninsured people in the country.
The groups disagreed strongly with the Sunset staff report’s recommendation to abolish the Office of Public Insurance Counsel, which the authors said is no longer needed because Texas no longer allows consumers to participate in the rate-setting process. “Because of the increasing importance and complexity of insurance, OPIC needs to be strengthened, not abolished. The agency should have the authority to help individual and group health insurance consumers evaluate whether the rates they are quoted are fair,” said Bruce Bower, an attorney with the nonprofit Texas Legal Services Center.
Sunset staff qualified their recommendation to abolish OPIC, saying if legislators decide to strengthen TDI’s role in making insurance accessible and affordable, then they might want to keep OPIC. Bower commented: "Before the Legislature makes any decisions about TDI or OPIC, it must first decide what it has the will to do about the health insurance market. If the Legislature wants to create the kind of fair market that Texans deserve, then the Legislature will strengthen TDI’s role in enforcing the rules and keep OPIC as a watchdog."
Toni McElroy, president of Texas ACORN, said Texans want strong legislative fixes for the private insurance market. “Working Texans will be talking about this problem in the coming months, and I hope legislators are listening,” McElroy said.
The advocates announced that they will be jointly sponsoring a series of town hall meetings on health insurance around the state throughout the summer. The first meeting is scheduled for June 12 in Houston.
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