Harris County’s publicly-funded hospital and clinic system, which includes Ben Taub, is restricting the number of people who qualify for free healthcare. The new eligibility rules will affect almost 20,000 uninsured patients.
The patients are currently uninsured, but according to officials at Harris Health, 77 percent of them could get insurance through the Affordable Care Act.
They just haven’t yet because paying premiums and deductibles on those plans currently costs more than just going to Harris Health and paying nominal fees such as $3 per visit.
“If you look at the out-of-pocket costs for insurance and the cost of free services, almost anyone would do the math and say why should I pay more?” said Mike Norby, Harris Health’s CFO.
Harris Health had previously offered virtually free care to people earning less than 200 percent of the federal poverty level. Starting in March, the free care threshold will drop to 150 percent of the federal poverty level. An individual would only qualify if she makes less than $18,000 a year.
The board managers of Harris Health voted 7-1 Thursday morning to change the eligibility. They hope patients who earn more money than the new income threshold will enroll in the subsidized insurance plans available through the Affordable Care Act. Enrollment begins November 1.
“I think it’s a move in the right direction,” said George Masi, CEO of Harris Health.
Harris Health is facing a projected deficit of $53 million in the next fiscal year. The change in patient financial aid will cut the system’s deficit, but only by half.
Masi says the deficit would disappear completely if the state’s Republican leaders would only expand Medicaid health coverage. Harris Health could then move 70,000 uninsured patients into Medicaid, netting $87 million in new revenue.
“If you do a root cause analysis, and you want to talk about the reason, or reasons – clearly, in my opinion, it’s the failure of the state to adopt Medicaid in an expanded fashion, per the Affordable Care Act,” Masi said.
Republicans in Texas and some other states have refused because the expansion is linked to Obamacare.
Masi said he is hopeful Republicans in Texas will eventually expand Medicaid, but it won’t be for a few years, at least.
“Who knows what else is going to happen in the larger political sphere, but this gives us a lot of breathing room,” Masi said.
The board managers said Thursday they might have to restrict financial aid even more next year. Norby said there is already a freeze on capital improvement projects and maintenance has been deferred. Waiting times for appointments could also increase.