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Health Care Reform: We Got it Done

Moments ago, the U.S. House passed historic health care legislation. With President Obama's signature, health care coverage will be the law of the land.

Thanks to the members of Texas' Democratic Congressional Delegation for providing the votes and the hard work that got reform across the finish line. Their votes will help clean up the health care crisis in Texas that Rick Perry and Republican leaders have refused to address.

After years of being victimized by the colossal abuses of the health care status-quo, Texans and Americans scored a victory. The health care legislation passed today will give health insurance access to 31 million Americans and most of our state's 6 million uninsured residents.

Today's accomplishments take the advantage away from the insurance companies and put it back in the hands of Texans and the American people. No longer will Americans be driven into debt by health care costs, be denied coverage based on a preexisting condition, and be indiscriminately dropped from their policy when they’re sick and need it most.

Because of our dismal health standings, Texas stands to gain the most from this legislation. I intend to work hard to ensure that this legislation is implemented effectively in our state, so that quality health care becomes more affordable and more accessible for all of our families.

This legislation moves Texas and America forward. Our country is back on the right path.

Statistics tell a sobering story in black and white

Cartoon by RJ Matson

The U.S. House is expected to vote on health care legislation tomorrow afternoon. As I've said before, Texas has the most to gain from reform given our dismal health standings. Today's Houston Chronicle ran an op-ed that I wrote on the subject. You can read it here, or below. You can also read a version of my op-ed in Spanish here.

The Congressional Hispanic Caucus (CHC) has endorsed the health care legislation because it will increase access to coverage to millions of Americans including 8.8 million Latinos. Texas Congressman Charlie Gonzalez, the First Vice Chair of the CHC, stated “We are ready to make the historic vote that will improve the health of all Americans, including Hispanic Americans.” To read the press release from the CHC in its entirety click here.

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Statistics tell a sobering story in black and white
Dems’ health plan good for people and for business

By STATE REP. GARNET F. COLEMAN
HOUSTON CHRONICLE

Statistics tell a story, and when you look at the troubling health care numbers in our state, it's clear what that story is: Everything's bigger in Texas.

Whether you're looking at the 1.3 million uninsured residents of Harris County or the 7 million insured Texans who spend 10 percent of their income on health care, it's clear our state needs to head in a new direction. And when you see that a leading Texas economist says spending on health care has a short-term multiplier effect — meaning federal health care legislation would result in more than $400 billion in economic activity in Texas — it's clear our state could greatly benefit from federal health care legislation.

For the 18 years I've served in the Texas Legislature, I've worked on health care issues in our state. I've worked with Republicans and Democrats, suburban, rural and urban members, doctors, nurses, patients and all the insurance company bureaucrats in between. I've seen the best and the worst of our health care system, and I've come to the same conclusion as most Americans: The current system is unsustainable and in dire need of reform.

As I said, statistics tell a story, and being first in the nation for the number of uninsured says there are leaders in Texas who are hostile to reform and unwilling to ensure their constituents have health care. Enrollment in the Children's Health Insurance Program just recently reached the same level where we were in 2003 when Republican lawmakers slashed hundreds of thousands of children off the rolls. If we're fighting to remain competitive with 2003 levels, it's clear that it's up to the president and Congress to enact reform that will benefit all Americans, but most especially Texans.

Because the majority of Texas businesses are small businesses, it's necessary to remove the great burden they face under current law. Federal reform will ease the struggle for small businesses that have to choose between increasing health premiums on their employees or dropping their coverage altogether.

At times this whole Sisyphean endeavor can seem dismaying. Seven different times, seven different presidents have pushed this huge health care reform boulder to the top of a steep hill, only to see it roll back down again, sending us back to the beginning. I'm determined not to let this be the eighth time.

It's necessary to pull our heads out of the daily grindings of process stories and legislative minutiae and remember why we're in this fight. All Americans have fallen victim to our current health care system, not just the ones who are uninsured. We've all heard the stories about insurance companies not playing fair. At a time these companies are reaping record profits, they are unscrupulously raising their rates on customers.

Out-of-control costs are adding another load to the backs of families strapped for cash in a tough economy. Insured individuals are paying higher premiums, higher deductibles and out-of-pocket expenses, while receiving fewer benefits. Furthermore, they carry the additional burden of paying for the care of the uninsured who may be only one illness away from bankruptcy.

These sobering statistics emphasize the need to rewrite the rules in favor of the American people. The health care legislation in Congress is a carefully crafted package that will insure 32 million Americans, give unprecedented security and stability to those with insurance and cut the federal deficit by $1.3 trillion.

Health insurance reform will provide immediate relief to Texas families by preventing insurance companies from inexplicably and excessively raising their rates. It will cap the amount of money an individual can spend on out-of-pocket expenses, eliminate lifetime and unreasonable annual limits on benefits and ensure that families aren't driven into debt by health care costs. Additionally, it will stop insurance companies from denying coverage based on pre-existing conditions and prohibit insurance companies from kicking people off their policies when they're sick and need it most.

It's beyond clear that Texas needs federal health care reform. We'll continue to fight on a state level regardless of the outcome, but we can't really win the fight against the worst practices of the insurance industry without the help of our elected members of Congress and people of good will.

Let's get it done.

Coleman, a Houston Democrat, is a member of President Barack Obama's 32-member White House Working Group of State Legislators for Health Reform. He is also the chair of the County Affairs Committee in the Texas House of Representatives, chair of Progressive States Network, chair of the Legislative Study Group and senior ranking member of the Public Health Committee.

President Obama Committed to Immigration Reform

Please see below a note from Rebecca Acuna, a member of my staff.
-Garnet Coleman

As someone who holds immigration reform close to my heart, it has been an honor to work for a legislator who shares the urgency in the matter. I've been fortunate enough to closely monitor immigration policy under the leadership of Representative Coleman

Because of his constant advocacy and work on behalf of all communities, Representative Coleman was selected to serve as a member of the working group, State Legislators for Progressive Immigration Reform. As a co-chair of the Progressive States Network, Representative Coleman plays a hand at spearheading efforts to tackle immigration reform at the state level. His deep grasp of the matter has lead him to work closely with the American Jewish Committee on their Bridging American Project, a task force aimed at making immigration reform a reality.

For those of us determined to see comprehensive immigration reform tackled this year, it was encouraging to learn that President Obama is committed to the issue and will not put it on the back burner. Congressman Luis Gutierrez, a champion of immigration reform who was withholding his vote on health care, agreed to cast a vote in favor of health care after meeting with President Obama to discuss immigration reform. After the meeting, Congressman Gutierrez said the President was committed to moving forward on a comprehensive immigration reform package as soon as possible.

On Sunday, thousands of immigrant rights reformers will convene at our nation's capital to urge swift action of humane, and comprehensive immigration legislation. We stand with these supporters and applaud their actions.

We will keep you up to date, as this important issue continues to develop.

Latest from Washington: Health Care Reform a Deficit Reducer

Cartoon by Mike Luckovich

I'm in Washington, D.C. meeting with our leaders in Congress as they prepare to take a final vote on health care reform. Today, the nonpartisan Congressional Budget Office reported that the health care bill passed by the Senate, along with the changes proposed in the reconciliation bill, will reduce the federal deficit by $1.3 trillion and insure 32 million Americans. These figures mean that this bill reduces the deficit by more than the versions already passed by the House and Senate, and insures more Americans than the Senate version. House Majority Leader Steny Hoyer correctly said that this health care legislation will be the largest deficit reducer in 17 years.

The current health care system is failing us. It's crippling family, state and federal budgets, and disproportionately hurting middle-income Texans. A report released yesterday by the Robert Woods Johnson Foundation showed that middle-income Texans are losing their health insurance at alarming rates. Between 2000 and 2008, 2.3 million middle-income Americans lost their health insurance. Texans accounted for 500,000 of that total, meaning that 1 in 5 middle-income Texans lost their health coverage. During the same time frame, family health insurance premiums in our state rose by 76 percent, although median incomes declined by 4 percent.

These final days are critical not only to the health care bill but also to Texans struggling under the current system. Please contact the following members of Congress and ask them to cast a final vote in support of health care reform.

Contact:
Representative Henry Cuellar	(202) 225-1640
Representative Lloyd Doggett	(202) 225-4865
Representative Charles A. Gonzalez	(202) 225-3236
Representative Al Green	(202) 225-7508
Representative Gene Green	(202) 225-1688
Representative Ruben Hinojosa	(202) 225-2531
Representative Sheila Jackson-Lee	(202) 225-3816
Representative Eddie Bernice Johnson	(202) 225-8885
Representative Solomon Ortiz	(202) 225-7742
Representative Silvestre Reyes	(202) 225-4831
Representative Ciro D. Rodriguez	(202) 225-4511

Houston Chronicle & Judson Robinson III: Pass Health Care Now

A Houston Chronicle editorial today urges Democrats in Congress to move at full speed to pass health care reform and lead us to a better, more secure future. The editorial highlights the risks that doing nothing would have on health care costs, individuals with pre-existing conditions, and our already unstable economy.

Also in today's Houston Chronicle is an op-ed by Houston Area Urban League President Judson Robinson III, in which he stresses the moral imperative of a just and equitable health insurance system and the necessity of being healthy to obtain and keep a job. He notes that health care reform legislation would be especially beneficial to our state, and even more so to Harris County, where more than half a million uninsured individuals reside.

I've included both pieces below.

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Showdown: Congressional Democrats should stand tall and back health care reform

Copyright 2010 Houston Chronicle
March 17, 2010, 12:29AM

It's crunch time on health care reform for congressional Democrats, especially those in the House of Representatives in potential swing districts. After months of discussion, an up or down vote on reform is likely to come before the end of the week.

Or perhaps not: The House Democratic leadership is considering using a procedure that would bypass a direct vote and spare vulnerable members the risk of an up or down vote. This is wrongheaded. As strongly as we support reform, we believe Congress should have the courage to vote on it directly. An end run would only stoke the already deep public cynicism about Washington's ways.

We understand the temptation. As a showdown approaches, undecided Democrats are being warned by Republicans, in no uncertain terms, that supporting their president on reform will cost them their jobs in November.

It may. But the greater risk by far, we would submit, is to do nothing.

Doing nothing would keep some 30 million Americans in a costly health care limbo that also would ramp up costs for millions more citizens with full insurance.

Doing nothing would only guarantee that health insurance costs continue to skyrocket with no relief in sight and no effective means of controlling them.

Doing nothing would mean that millions with pre-existing conditions would still be unable to qualify for coverage.

Doing nothing would hinder the all-important jobs recovery that making health care mobile and universally available would strongly support.

The Republicans have made their choice. They are in lock step against passage of the president's plan. That is not a pretty picture. It does not speak well for the health of our supposedly collegial political system. But it is also their right.

The Republican refuseniks have their reasons. Some are philosophical. Many have honest disagreements on approach, as was made clear in the recent health care summit.

But other GOP motives are unabashedly calculating and political, having nothing to do with health care. These are aimed squarely at winning back congressional seats in the November elections and, two years hence, defeating Barack Obama. The Republican leadership is persuaded that Obama is vulnerable on health care and can be taken down with a loss on this major pledge of his 2008 campaign.

We believe this is a bad bet and a narrowly self-interested approach that will be seen through and rejected by informed voters.

We believe it's a smart bet for wavering Democrats to stand with their president and accomplish this major policy objective.

We strongly encourage members of the Democratic rank and file to stand with their president and support health care reform in this critical hour.

This is one of those votes that will shape the American future, for better or worse. We believe a better, more secure future will result from a decision to take this step of reform.

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Health care reform: It's time to get the job done
By JUDSON W. ROBINSON III
March 17, 2010, 12:34AM

As president and CEO of the Houston Area Urban League, I personally experience the daily challenge of working with individuals seeking help in becoming more productive. We all benefit when these individuals seize opportunities to improve their status in life. At the Urban League, we focus on bringing personal and community economic empowerment to the most vulnerable Houstonians by hastening their pace toward self-sufficiency. The sooner people become self-sufficient, the more independent they become. The moral imperative of having a just and equitable health insurance system is one of the cornerstones of that empowerment.

There are many misconceptions about the intentions of the health care bill being debated in Washington, D.C. It is important to note the impact that passage of this legislation would have on real Houstonians, particularly those most in need.

The health care bill includes key, common-sense provisions that would ensure access to affordable coverage for Houstonians. These provisions include: prohibiting discrimination based on pre-existing conditions, ending the practice of dropping policyholders when they become seriously ill, ending lifetime caps on coverage, reducing out-of-pocket expenses and ensuring access to preventive care and expansion of Medicaid to many adults who live in poverty. Expanding Medicaid to low-income adults would be particularly beneficial to the health of our state, given that approximately 32 percent of Texas adults are uninsured. More than half a million of Texas' 6 million uninsured residents live in Harris County. Every day, 470 Texans lose their coverage as a result of rising premiums, obscene out-of-pocket expenses and being diagnosed with a catastrophic illness.

Certainly, the costs associated with coverage for the uninsured warrant close inspection, but so do the tremendous increases in premiums and the outrageous profits for some insurance companies. Long-term cost avoidance is critical to the public's welfare. According to the Congressional Budget Office, we will save approximately $118 billion over the next 10 years and another $600 billion over the second 10 years once health reform is enacted. The bills that have passed would cap consumer spending, ensuring that no one has to fear bankruptcy when paying for care. The bills passed by Congress would take great strides in providing Children's Health Insurance Program and Medicaid coverage to children from middle- and lower-income families while allowing small businesses affordable coverage for their employees. The legislation calls for expanding Medicaid eligibility to everyone who is living at or near poverty, which would increase access to affordable coverage and bring coverage to about a million low-income uninsured adults in Texas.

One of the issues we focus on at the Urban League is health education. We must do a better job of taking personal responsibility for our own health. Provisions of the health care reform legislation provide incentives for prevention of illness and for healthy eating.

This legislation is such a significant step forward that we must not lose sight of all the good it does. Never before has our country been this close to realizing the dream of health insurance reform. For 60 years, we have pursued a way to increase the likelihood of community wellness while enhancing the quality of life and care for our citizens. There is much work to be done in this country. Housing, education, the environment and, as we all know, jobs deserve a big slice of our focus. But to have a job, you have to be healthy. To keep a job, you must stay healthy. Let's get this done and move on to other pressing concerns facing Houstonians.

Affordable health care should not be the privilege of the fortunate few. It is the issue of our time, and Congress should deliver reform for the good of our country.

Robinson is president and CEO of the Houston Area Urban League.

Homeowner Insurance Rates Continue to Rise

State Farm Insurance announced that they are imposing a 4.5 percent rate hike on homeowners insurance a mere seven months after enacting an 8.8 percent rate increase. The Legislative Study Group, a House Caucus that I chair, compiled a policy update on homeowners insurance legislation in Texas and proposed solutions to the problem. You can also read a memorandum on the subject from Texas Watch here.

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LSG Policy Update: Homeowner Insurance Rates Continue to Rise

State Farm Increases Homeowner Insurance Rates

State Farm has announced that they will raise homeowner insurance rates by 4.5 percent in May. This comes on the heels of an 8.8 percent increase in October.1 Texas homeowners already pay the second highest insurance premiums in the country; such a steep rate increase hurts Texas homeowners financially as they navigate through the worst recession in a generation.

Unfortunately, this is not the first time that Texas homeowners have been charged excessive premiums. In November, State Farm was ordered to repay its customers $310 million for overcharging homeowners for coverage dating back to 2003.2 This sum was actually $700 million less than what consumer advocates and the state's Public Insurance Counsel recommended.

In addition, the policies provided by State Farm and other companies have cut back on the level of coverage provided to Texas homeowners, meaning Texans are effectively paying more while getting less.

Background on Insurance Legislation in Texas

As a result of a dramatic increase in mold claims prior to 2003, homeowner insurance rates were pushed to record heights. In response, legislators in the 78th Legislature passed SB 14, which, among other things, moved Texas to a "file and use" system.

Previously, rates were established by the Commissioner of the Texas Department of Insurance, and companies had to petition the department for approval to raise their rates above the established level. However, a loophole allowed most companies to shift their policies outside of the regulations, meaning consumers still saw high premiums.

The "file and use" system passed in 2003 did little to alleviate the problem. Under the new system, insurance companies were simply required to inform the department of a rate change before they implemented it. The department had no mechanism to regulate insurance companies as they implemented premium rates.

Texas homeowners have failed to see any significant relief from the rates that were in place prior to 2003.

Texas Department of Insurance

The Texas Department of Insurance has not undergone a sunset review since 1993. As mentioned previously, there have been many significant developments in the insurance market in Texas during that time.

The department was slated to undergo its review during the past legislative session, but the Legislature failed to act before adjourning Sine Die. A special session was called to pass a safety net bill that extended the life of the Department of Insurance and five other agencies until 2011.

It is unfortunate that the TDI sunset bill did not reach the floor of the House for a vote. Since the 2003 session when lawmakers passed, and Governor Perry signed, the ineffective "file and use" system, lawmakers have proposed a "prior approval" system that could provide effective relief for Texas homeowners. Such legislation was drafted again this session as an amendment to be voted on by the House during floor debate on the sunset bill. Lawmakers that filed such amendments included Representative John Smithee and LSG members Representatives Jessica Farrar and Trey Martinez Fischer.

Similar bills were filed during the 81st session by LSG members Representatives Anchia, Coleman, Herrero, Martinez Fischer, Rose and Vaught. On the Senate side, Senators Van De Putte, Hinojosa, and LSG member Senator Ellis also filed legislation.

Ineffectiveness of Department

Since no legislation that gave such regulatory power to the Department of Insurance passed, insurance companies are free to continue raising rates. The Commissioner has been left only with the ability to write a disapproving letter to companies.

After State Farm informed the Department of Insurance that they would institute a 4.5 percent hike a mere seven months after an 8.8 percent hike, Mike Geeslin, the Commissioner of the Texas Department of Insurance, wrote in a letter to State Farm3:

"The timing of this filing causes me concern. State Farm Lloyds last rate change for its homeowners program was an increase of 8.8% effective September 1, 2009, for new business, and October 1, 2009 for renewal business. State Farm Lloyds has had this increase in effect for only seven months. Multiple rates increases within such a short period of time may indicate a lack of rate making discipline and lead to market instability.

Given that State Farm Lloyds is the market leader, writing nearly 30% of the homeowners market, other companies may follow suit which would lead to further market instability. It appears that the timing of this is not in the best interests of Texas consumers. Consumers deserve a stable and competitive market. It is my hope that State Farm Lloyds reconsider the timing of this filing and will voluntarily withdraw it."

(emphasis added)

Prior Approval

Currently, while acknowledging the damaging effect of multiple rate increases, the best that the Department of Insurance can do is ask State Farm to "voluntarily withdraw" their rate increase.

The Legislature should pass real insurance reform for Texas homeowners to rectify this disappointing lack of proper regulation. Included in such reform should be a "prior approval" provision, similar to the ones filed by lawmakers in past sessions. Such a system would require the Commissioner of Insurance to approve a rate increase before a company can implement it. This would ensure that insurance companies justify their rate increases, protecting policyholders from excessive charges.