Sylvia Burwell, the secretary of U.S. Health & Human Services, visited Parkland Memorial Hospital Tuesday to highlight Dallas as one of her top enrollment targets for the Affordable Care Act ahead of the upcoming open period, which begins Nov. 1.
She came to North Texas a day after the release of an HHS analysis that found Dallas-Fort Worth customers will pay an average of 3.9 percent more than the year prior for the second-lowest silver plan, which was used as the study’s benchmark. Statewide, the average increase is 5.1 percent. And Dallas-Fort Worth actually made it out OK, when looking at other major metro areas in the state. Austin, for instance, will see an average spike of 10.1 percent. Houston’s is 4.9 percent.
Despite notching 1.2 million registrants at the end of the last enrollment period, Texas remains the state with the worst uninsured rate—19.1 percent, according to recent data from the Centers for Medicare and Medicaid Services. So it is perhaps no surprise that two of its largest cities are among the five that Burwell will visit on her promotional trip. She was in Houston on Wednesday, and will visit Miami, Chicago, and New Jersey.
During the trip here, she gathered with about a dozen stakeholders (including Parkland CEO Fred Cerise and Mayor Pro-Tem Monica Alonzo) for a roundtable about the efforts and progress being made in getting Texans, particularly North Texans, signed up for the Affordable Care Act. Parkland, which Cerise said spends 48 percent of all its care on uninsured residents, and the taxpayers benefit when its patients get enrolled in healthcare, she said.
Despite the increase in average plan costs, Burwell still defended the marketplace plans as affordable. The analysis found that eight of 10 customers can buy a plan with premiums less than $100 a month after tax credits. Seven of 10, the analysis found, will find an available plan for less than $75 a month. Last year, the analysis found, about 53 percent of returning customers shopped around and saved an average of close to $400 on the new, same-tiered plan.
“People knowing that this is something they can afford and we know that eight of 10 folks that were enrolled last year can come back into the marketplace and with the financial assistance they can find premiums that are $100 or less,” Burwell said.
She brought forward Shaun Hubbard, a PHD student at the University of Texas at Dallas who is married to a hairstylist at a small salon. He told the room that she was expecting, and that they purchased health insurance on the exchange. The baby had to be born early and suffered complications, which required surgery—surgery that, he says, quickly rang up to about $3 million.
“Our premiums were approximately $500 a month with a $6,000 deductible,” he said. “I get people all the time telling me, ‘$6,000, that’s a lot of money.’ But if you look at it compared to the nearly $3 million in medical bills he’s had since he was born, it doesn’t seem like so much. Without the ACA, we’d be bankrupt.”
What comes next for the ACA? Burwell says education remains a challenge, both for enrollees and those who have yet to buy coverage. So the feds are tweaking its offering to be more user friendly and explanatory, she added. There’s now an estimator tool on the website that allows the user to see how much their out-of-pocket costs would be with each plan. Previously, volunteer organizations and the insurance companies had to help customers get into the more granular cost aspects. Healthcare.gov is now making moves to help in that process. Advertisements are plastered on buses and broadcast in unusual settings, like Laundromats.
“It’s very important that people get the insurance, but once they get it we need them to use it to impact their health,” she said.
An aside: Burwell acknowledged that the Obama administration was keeping an eye on the state of Texas’ attempt to remove Planned Parenthood from the Medicare program. Earlier this month, the Office of Inspector General notified its state affiliates that alleged safety violations shown in videos taken undercover at their offices warranted a patient risk, which is enough to get booted from the program. Days later, the state announced it was also investigating whether Planned Parenthood billed for procedures that are not eligible for federal reimbursement.
When asked, Burwell spoke of the preventive and wellness services offered at Planned Parenthood locations and said HHS is “aware” of the “funding issues” but hasn’t taken any action.
“I would just add that HHS right now is doing what we’ve done with other states, which is communicating with the state about our concerns to make sure that people are obeying what are traditional Medicaid statutes in terms of access to providers,” she said. “We’ll make sure that we, as we have with others states, that we’re communicating clearly about the standards of being able to go to qualified providers.”