Affordable Care Act changes high risk health insurance coverage in Texas

Like many states, up until the passage of the Affordable Care Act, Texas maintained a separate insurance pool for high risk individuals who could not obtain insurance from another source.

In Texas, that pool was known as the Texas Health Insurance Pool.  The Texas Health Insurance Pool insured individuals, such as those with pre-existing conditions, who could not obtain insurance from other sources.   As would be expected, the premiums, which reflect the higher health risk of the insured, offered by the Texas Health Insurance Pool were significantly higher than the rates offered by non-high risk insurance companies.

The Affordable Care Act and the Health Exchanges have changed high risk health insurance in Texas.  The Texas Health Insurance Pool no longer offers insurance policies and refers those individuals to health.gov for enrollment in the Federal Insurance Market system.

So how do the rates compare?  The rates under the Affordable Care Act are generally lower than the rates offered by the old Texas Health Insurance Pool.  For instance, consider a 53 year old, male smoker who had pre-existing health issues.  If this person were to select a gold level plan under the Affordable Health Care Act, which does not take the pre-existing conditions into account, they could expect to pay about $850 a month.  The same person would have paid about $1,500 a month under the old Texas Health Insurance Pool.

Published by

Dwight Steward, Ph.D.

Dr. Steward regularly writes and speaks on topics involving business and individual economic damages, employment audits, and the analysis of payroll and time data in wage and hour investigations. Dr. Steward has also held teaching positions at The University of Texas-Austin in the Department of Economics and in the Red McCombs School of Business, The College of Business at Sam Houston State University, and at The University of Iowa. He has taught numerous courses in statistics, corporate finance, labor economics, business policies, managerial economics, and microeconomics.