By MITCHELL SCHNURMAN
mschnurman@star-telegram.com
In contrast, some states set average rates or "community ratings" that limit the pricing differential. The healthcare reform bills in Washington address this issue by limiting the maximum premiums to a multiple of the lowest price offered in the marketplace.
A House bill proposes a limit of two times the lowest premium; a Senate version sets the maximum at four times. This would allow insurers to charge more for sicker and older customers, without going so far that they price people out of the market.
The differential is much smaller among large employers in Texas — just 2.6 times greater than the average, according to the center report. That’s because big companies have more leverage in negotiations, so they get better prices.
Unfortunately, a lot of people in Texas don’t get insurance from large employers or from employers at all. Just under 49 percent of Texans have employer-sponsored insurance, compared with an average of 56 percent for the nation (and 88.5 percent in Hawaii).
It’s part of this group that stands to benefit from a public option. The government plan would be added to a health insurance exchange that includes private carriers and offers several tiers of coverage. The public option would be offered to individuals, as well as employees of small companies whose plans were too expensive or limited in coverage.
Most participants in a company-sponsored plan wouldn’t be eligible for the public option. Most people say they’re satisfied with their current insurance, and employers have enough clout to get good deals.
The Congressional Budget Office estimates that about 30 million people would participate in the healthcare exchange, with about 12 million choosing the public plan. That compares with about 170 million Americans who have health insurance through their employers, which is why Obama has said the public option should not be a deal-breaker.
All this may prove to be a moot point. The public option wasn’t included in the Senate Finance Committee bill but was reintroduced this week with a compromise that lets states "opt out" of the option.
It’s not clear how states would do that and whether the entire Legislature would have a say. But Gov. Rick Perry has been hostile toward Washington initiatives, and his office was skeptical of the latest wrinkle. "The bottom line is a massive government takeover of healthcare is not the solution," Katherine Cesinger, deputy press secretary, said in an e-mail statement.
Like it or not, reform is coming, and Texas stands to be one of the big winners. For people looking to the health insurance exchange — and there will be a lot of them in Texas — the public option could make it even better.
Mitchell Schnurman’s column appears Sundays and Wednesdays. 817-390-7821
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