Governmental Issues

TAB Issue Area: Health Care

Area Manager: Shelton Green,
Governmental Affairs Manager
512-477-6721 x117  sgreen@txbiz.org

Current Efforts

Employers & Health Care: Crisis and Solutions, 2006 Report

TAB 2006 Health Care Conference Presentations

Texas Senate Committee on State Affairs - Transparency Panel Testimony

Employers and Health Care: Crisis and Solutions - 350 KB
No Easy Cure—Texas’ Health Care Crisis 2004, Presentations
Consumers Union teams up with TAB to support hospital accountability(Opens in new window)
Survey of Texas Voters -- Public Attitudes on Health Care Issues - 1.7MB.
Texas Health Insurance Crisis -- Employers & Healthcare: 2002 Report(Opens in new window)
Texas Health Insurance Crisis Summary- 238 KB.
Texas Health Insurance Crisis -- Solutions (Summary)(Opens in new window)
Texas Health Insurance Crisis -- Solutions (Summary) 394 KB. TAB Unveils Its Health Care Solutions to Reduce Costs and Increase Access 1.7 MB. (Opens in new window)

TAB created the Health Partners Task Force in 1997– a coalition of over 400 employers and their employees — to advocate for legislation to improve affordability and accessibility of health insurance. 

After rising rapidly for many years, increases in health insurance premiums slowed during the mid 1990's as the number of employees enrolled in managed care plans increased.  Now, however, health insurance costs are back on the rise again. In fact, health care spending is expected to reach $2 trillion by 2008 and the vast majority of this will be paid by private employers who are providing health insurance voluntarily (Source: Health Care Financing Administration).

Why are costs rising? Hospital and physician costs comprise the largest share of the nation's health care spending and continue to outpace inflation. In  addition, as government has cut Medicare and Medicaid payments, it has driven down payments to hospitals and physicians who are now looking to the private sector to make up losses and to subsidize care furnished to the uninsured (Source:  HIAA "Why Do Health Insurance Premiums Rise?).
 Increased government regulation of the health insurance industry, including new coverage mandates, also contributes to premium growth. For instance:

• From 1998 to the end of 1999, the number of mandates increased 9.4 percent.
• There were 1,391 such mandates in all 50 states at the end of 1999, compared to just 5 mandates in 1968. (Source: National Center for Policy Analysis).
• Five of 63 mandates in Texas are said to have raised premiums 17%.

In addition to rising costs, more and more consumers are joining the ranks of the uninsured. Texas, for instance, has the most uninsured residents than any  other state in the country. Small businesses are finding it harder and harder to provide benefits as costs go up. Seventy–eight  percent of small businesses – nearly 8 out of every 10 – consider affordable health  insurance their top concern (Source: Plan Sponsor Magazine July 2000, American Express "Voices from Main Street"). When costs go up, some are forced to drop coverage altogether resulting in more uninsured. Forty-four million Americans are without health insurance, approximately one-fourth of Texans have no health insurance whatsoever and the number is on the rise (Source: NAM, July 17, 2000 Newsletter).

Members of TAB's Health Partners Task Force have sought to bring employers to the forefront of the health insurance debate to ensure preservation of a private, market-driven health care system for Texas and the nation that is affordable and accessible for all. Additionally, we are seeking an aggressive program that will improve access to medical information and new  technologies, patient safety and anti-fraud initiatives that will improve access, quality and affordability of the system. The following are TAB's Health Partners Task Force 2001 Legislative Priorities that will help  accomplish these goals:

Access. Increase access and choice of healthcare programs by supporting market-driven health policies that maximize consumer and public benefit and allow for the continuation of employer-sponsored voluntary health care coverage. Programs should be explored that would allow employers selection of the highest quality benefits and the lowest, most competitive prices.

Employer liability. Prevent needless increases in cost and litigation through the expansion of employer and health plan liability. Oppose and/or modify any legislation or existing statute that creates or expands causes of action against employers and insurance carriers for medical negligence or harm incurred by health care providers.

ERISA. Preserve employer, employee and health care system benefits of ERISA by opposing any further attempts to erode the federal preemption of state law relating to health benefit plans. Protect employer administration of self-insured plans from any federal causes of action or exposure to state courts. Accessibility of ERISA by small businesses, their workers and the unemployed should be allowed.

Fraud and abuse. Eliminate waste, fraud and abuse in public and private sector health programs. 

Mandated benefits. Assure that the high cost of mandated benefits, services and other requirements to employers and employees are fully considered in legislative decision-making.

Market flexibility. Ensure market-based solutions and approaches are used in our health care system. Support making coverage more affordable by monitoring and opposing health insurance regulations that increase the costs and undermine the concept of a free market for contractual medical services.

Medical information. Foster medical information and profiles of providers for health care purchasers and their employees, including the collection and sharing of cost and quality data. Stimulate improvements in quality of care and consumer comparisons. Encourage employees to be more involved in their health, and encourage education of cost-awareness and preventative health care. Promote understanding that a healthy employee and a health family create a productive workforce. The development of information technology is critical to improve quality and decrease fragmentation while protecting patient confidentiality. 

Medical innovation. Encourage medical and health benefit plan flexibility and innovation to maximize consumer choice.  Continue to allow employers to voluntarily provide health care coverage to their employees.

Medical savings accounts. Empower individuals to better handle their share of health care costs by improving access to coverage through the expansion of Medical Savings Accounts at the federal level and by promoting its use by the state's Employees Retirement System program. This would enable employees to use pre-tax dollars to pay for health care services, create more accountability for health care purchasing decisions and allow individuals a federal income tax deduction for purchasing health coverage.

Patient Safety. Ensure patient safety and control costs by reducing the number of medical errors. Promote affordable, quality and safe health care.

Uninsured. Support targeted, market-based reforms that enhance the employer-based system to provide affordable access to quality care. Encourage greater voluntary participation on behalf of individuals by expanding access and choice.