Texas Must Decide Which Health Benefits to Require
As a result of the federal health care overhaul, Texas now has to figure out which health care benefits it will require insurance policies to provide. Under the health care law, ten categories of benefits must be included in many plans sold to individuals and small businesses. Those benefits might include maternity or prescription drug coverage.
Analyst Stacey Pogue with the Center for Public Policy Priorities says the deadline for the state to decide is Sept. 30. Pogue suspects the Governor’s office or the Texas Department of Insurance will make the decision, because the Legislature is not in session. If no decision is made by the deadline, the state will use a fallback plan.
“So if the state doesn’t make a choice, the choice we end up with is the largest health insurance plan that’s currently sold to small employers in the state,” Pogue said. “And that will be used as a benchmark to measure against those benefits of what needs to be included in plans in 2014.”
Pogue says things like emergency room care and doctor’s visits are generally covered, but the essential care requirements set the stage for more comprehensive care.