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Texans Struggle for High Risk Pools

Texans Struggle for High Risk Pools

Even if there is health insurance, Texans struggle for high risk pools. Story of Austin-based musician Chris Johnson supports this fact. He was not getting any healthcare coverage because of his esophageal disorder and suddenly in 2002, after some sessions of illness; he got Texas Health Insurance High-Risk Pool which was a boon to him, at that time. But, very soon he realized that these pools are not always a guaranteed safety net for getting healthcare coverage. Increasing rate of premiums and rising medical bills ultimately made him bankrupt.

Not only Chris, there are hundreds in Texas who are enrolled in state health high-risk pool and suffering from the same problem. However, there are many who are enjoying maximum benefits of high-risk pools; rather these pools have prevented them from being bankrupt.

However, they are hopeful that the healthcare overhaul bill would provide relief to the insured as well as uninsured Texans.

According to some of the risk pool personnel, these pools provide value added services. These keep insurance rates reasonable and significantly lower for the commercially insured people.

  • Plans offered by high-risk pools are meant to help the middle-class Americans who are otherwise considered as uninsurable or not able to afford private health insurance.

As proposed by 3 U.S. House committees that all Americans should get insurance coverage; especially though high-risk pools. But, still Texans struggle for high risk pools.

The higher rate of premiums is a problem for those who are needed by state law to charge higher the market rate.

As of 2008, Texas high-risk pool's report showed that customer satisfaction was higher especially among the pool members who cancelled their coverage (some of them got jobs with healthcare coverage and some others become old for Medicare). But, majority of negative comment was related to the high rate of premiums.

Chris said he had to pay 400 USD in 2002, but is paying $700 now. And, he has already got letter informing latest price hike.

25% of the total numbers of people who have left risk pool in 2008 were suspended because of non-payment of premium.

Texas Legislature wanted to aid people enrolled in the risk pool paying their premiums. TX lawmakers passed a bill named House Bill 2064. The bill will be effective from 2011. Until then Texans struggle for high risk pools.

  • The bill would provide a premium discount of 50% to the Texans whose total household income is under 200% of national poverty level.
  • It would also provide a 30% premium discount to the Texans whose household income is between 200% and 300% of the federal poverty level.

The legislation would be financially supported by the fines state charges against the insurance providers for disbursing claims late to the doctors and other medical professionals as well as hospitals and other medical providers.

Reports show that enrollment in Texas High-Risk Pool slashed in the previous year; probably for the recession. Basically, more people left pool than enrolled, in the last year.

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