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Myths v Facts 2017-05-25T13:12:02+00:00

The Texas Way Program is a uniquely Texan, private market-based health insurance coverage program that will improve the health of low-wage working Texans and strengthen the state’s economy.

The Texas Way Program:

  • Connects uninsured Texans with private market coverage choices;
  • Requires personal responsibility;
  • Promotes appropriate utilization of health care services; and
  • Reduces inefficient health care spending.

By requiring covered individuals to pay for a portion of their care and incentivizing the appropriate utilization of health care services, the Texas Way Program avoids the pitfalls of traditional entitlement programs. The Texas Way Program is the fiscally responsible approach to reducing the number of uninsured without adding to the state’s Medicaid rolls.

MYTH #1

We can’t afford the Texas Way Program because long-term costs will consume an ever-larger share of the state budget. The federal government will renege on its promise of contributing no less than 90 percent towards the cost of services.

FACTS

  • Hospitals and other health care providers are already paying for coverage expansion through more than $500 billion in cuts to Medicare and Medicaid over 10 years. The fiscally responsible choice is to allow hospitals and other health care providers to recoup their lost funds by having far fewer uninsured patients.
  • Texas can end the Texas Way Program at any time, without penalty. If costs become excessive, the state can end the program.
  • The Texas Way Program could stabilize the growth in local property taxes that currently pay for $1 billion in indigent health care services.
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MYTH #2

The Texas Way Program will discourage people from working and encourage government dependency.

FACTS

  • Nearly 80 percent of uninsured Texans are already working or are in a family with at least one working adult. Health insurance is not available to them as an employee benefit or it is unaffordable at their income level. Because of the state’s higher-than-average number of small businesses and the prohibitive cost of health insurance, Texas employers are far less likely than employers in other states to offer a health insurance benefit.
  • The Texas Way Program will include incentives to work.
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MYTH #3

Job creation is a more effective path to affordable health insurance.

FACTS

  • Texas already leads the nation in job creation, but low unemployment has not led to a decrease in the number of uninsured.
  • Because of the state’s higher-than-average number of small businesses and the prohibitive cost of health insurance, Texas employers are far less likely than employers in other states to offer a health insurance benefit.
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MYTH #4

The Centers for Medicaid & Medicare Services will never approve the Texas Way Program.

FACTS

  • CMS approved Texas’ existing 1115 Medicaid Transformation Waiver that implements numerous Medicaid reforms, including requiring managed care enrollment for nearly all Medicaid enrollees.
  • CMS is working with other states on private-market coverage models.
  • CMS has publicly expressed its willingness to work with Texas on developing the Texas Way Program.
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MYTH #5

The Texas Way will give undocumented immigrants access to health care.

FACT

  • Only individuals who are U.S. citizens or who are legal immigrants and have lived in the U.S. for more than five years are eligible for coverage through the Texas Way.
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MYTH #6

The Texas Way is just rebranded Medicaid expansion.

FACTS

  • The Texas Way proposes enrolling low-wage working Texans into private health insurance plans that cover the same benefits and have the same requirements that most people have if they get coverage through their employers.
  • With the Texas Way, Texas lawmakers have the opportunity to design a coverage option that reflects the needs and values of their constituents. Cost sharing, health savings accounts, incentives for employment and requiring personal responsibility are all possibilities.
  • Texas Way enrollees will not be part of the Medicaid system. Coverage is not an entitlement.
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MYTH #7

The Texas Way will increase the federal deficit.

FACT

  • The Texas Way would be paid for with dollars that Texas hospitals and other health care providers are contributing through Medicare and Medicaid funding cuts. Medicare cuts to Texas hospitals alone are $13 billion. These cuts were intended to offset the costs of increasing access to coverage for the uninsured.
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MYTH #8

Texas won’t be able to find the funds to pay the state share once federal funding decreases.

FACTS

  • The federal share of the cost never drops below 90 percent. The state share never exceeds 10 percent.
  • If the state’s share becomes onerous, Texas can end the program without penalty.
  • State general revenue dollars are already being used to pay for a patchwork of behavioral health and other health care safety net services for uninsured Texans. Some of these funds could be used more efficiently to pay the state’s share of comprehensive private health insurance through the Texas Way.
  • Texas is also achieving significant savings through its 1115 Medicaid Transformation Waiver that mandates managed care enrollment statewide. These savings could be used for the state share.
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MYTH #9

The Texas Way will just make existing problems with Medicaid worse.

FACT

  • The Texas Way will not expand Medicaid coverage. It is not adding enrollees to the Medicaid program.
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