Without the expansion, the Texas Hospital Association says the exchanges' effectiveness will be muted.
"Hospitals and other community-based groups are working hard to get as many uninsured Texans as possible enrolled in the best coverage option," says Dan Stultz, MD, FACP, FACHE, CEO of THA.
"Unfortunately, the missing piece of Medicaid expansion means the impact of health reform to reduce the uninsured population will be blunted. The state's decision to sidestep Medicaid expansion is an acceptance of the status quo where large numbers of the working poor do not have access to employer-based coverage resulting in limited access to comprehensive, affordable health insurance options."
David Salsberry, CFO and executive vice president of JPS, says another roadblock in Texas will be the provider network. He says he initially anticipated a significant change in patient load because their options would be greater, but if there are a limited number of physicians taking HIX patients, the impact will also be limited.
I thought, 'We're going to have a lot of patients who we may lose because they'll have more choice,' but what physicians are going to be willing to take those patients?" he says. "We have the largest family practice residency in the country, so at first I thought [we'd] run the risk [of losing patients], but now I don't think it's going to be as great."