Rep. Jackson Lee Celebrates Lives Improved by Affordable Care Act in Texas

WASHINGTON, Jan. 12 -- Rep. Sheila Jackson Lee, D-Texas, issued the following speech, which was published in the Congressional Record on Jan. 12, celebrating the lives improved by the Affordable Care Act in Texas:

Mr. Speaker, as a senior member of both the Judiciary Committee and the Homeland Security Committee, I rise in celebration of the over 1 million Texans who have gained healthcare coverage under the Affordable Health Care Act, and the millions of Americans more whose lives have been exponentially improved by access to substantial increases in life-saving coverage.

The data show that the uninsured rate in Texas has fallen by 28 percent since the Affordable Care Act (ACA) was enacted in 2010, translating into 1,781,000 Texans gaining coverage.

In addition to residents who would otherwise be uninsured, millions more Texans with employer, Medicaid, individual market, or Medicare coverage have also benefited from new protections as a result of the law.

With respect to employer coverage, 13,709,000 people in Texas are covered through employer-sponsored health plans.

Since the ACA was enacted in 2010, this group has seen:

(1) An end to annual and lifetime limits:

Before the ACA, 7,536,000 Texans with employer or individual market coverage had a lifetime limit on their insurance policy.

That meant their coverage could end exactly when they needed it most. The ACA prohibits annual and lifetime limits on policies, so all Texans with employer plans now have coverage that's there when they need it.

(2) Young adults covered until age 26:

An estimated 205,000 young adults in Texas have benefited from the ACA provision that allows kids to stay on their parents' health insurance up to age 26.

(3) Free preventive care:

Under the ACA, health plans must cover preventive services--like flu shots, cancer screenings, contraception, and mammograms--at no extra cost to consumers.

This provision benefits 10,278,005 people in Texas, most of whom have employer coverage.

(4) Slower premium growth:

The average premium for Texas families with employer coverage grew 3.5 percent per year from 2010-2015, compared with 8.1 percent over the previous decade.

Assuming Texas premiums grew in line with the national average in 2016, family premiums in Texas are $5,400 lower today than if growth had matched the pre-ACA decade.

(5) Better value through the 80/20 rule:

Because of the ACA, health insurance companies must spend at least 80 cents of each premium dollar on health care or care improvements, rather than administrative costs like salaries or marketing, or else give consumers a refund;.

Texans with employer coverage have received $20,082,448 in insurance refunds since 2012.

With respect to Medicaid, 4,770,229 people in Texas are covered by Medicaid or the Children's Health Insurance Program, including 3,512,929 children and 374,617 seniors and people with disabilities covered by both Medicaid and Medicare.

The ACA expanded Medicaid eligibility and strengthened the program for those already eligible.

An estimated 1,107,000 Texans could have health insurance today if Texas expanded Medicaid under the ACA.

Coverage improves access to care, financial security, and health; expansion would result in an estimated 127,000 more Texans getting all needed care, 157,400 fewer Texans struggling to pay medical bills, and 1,330 avoided deaths each year.

406,000 Texans, or an estimated 23 percent of those who could gain Medicaid coverage through expansion, have a mental illness or substance use disorder.

Texas could be saving millions in uncompensated care costs. Instead of spending $1 billion on uncompensated care, which increases costs for everyone, Texas could be getting $5 billion in federal support to provide low-income adults with much needed care.

Children, people with disabilities, and seniors can more easily access Medicaid coverage. The ACA streamlined Medicaid eligibility processes, eliminating hurdles so that vulnerable Texans could more easily access and maintain coverage.

Texas can better fight opioids. Under the ACA, CMS provided technical assistance that is giving Texas the opportunity to strengthen Medicaid services for people struggling with opioid abuse or other substance use disorders (SUDs).

With respect to Medicare, 3,765,946 people in Texas are covered by Medicare. The ACA strengthened the Medicare Trust Fund, extending its life by over a decade. In addition, Medicare enrollees have benefited from:

Lower costs for prescription drugs: Because the ACA is closing the prescription drug donut hole, 346,750 Texas seniors are saving $366 million on drugs in 2015, an average of $1,057 per beneficiary.

Free preventive services: The ACA added coverage of an annual wellness visit and eliminated cost-sharing for recommended preventive services such as cancer screenings. In 2015, 1,746,043 Texas seniors, or 72 percent of all Texas seniors enrolled in Medicare Part B, took advantage of at least one free preventive service.

Fewer hospital mistakes: The ACA introduced new incentives for hospitals to avoid preventable patient harms and avoidable readmissions. Hospital readmissions for Texas Medicare beneficiaries dropped 6 percent between 2010 and 2015, which translates into 4,960 times Texas Medicare beneficiaries avoided an unnecessary return to the hospital in 2015.

More coordinated care: The ACA encouraged groups of doctors, hospitals, and other health care providers to come together to provide coordinated high-quality care to the Medicare patients they serve. 37 Accountable Care Organizations (ACOs) in Texas now offer Medicare beneficiaries the opportunity to receive higher quality, more coordinated care.

Now is not the time to undermine or slow the ability of our insurance providers to address growing threats and active cases of Americans' health crises.

Accordingly, I urge all Members to join me in protecting the gains achieved by the Affordable Healthcare Act.

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