By Amy Einhorn, MPP, Senior Program Officer at St. David’s Foundation
Published November 9, 2022
It’s time for Open Enrollment in Texas and across the United States! Open Enrollment—from November 1 to January 15 each year—is when people in Texas can enroll in an affordable and comprehensive health coverage plan through the Affordable Care Act (ACA) Marketplace for insurance that starts in the next calendar year. Open enrollment is a vitally important opportunity for our region’s uninsured. Health insurance is a building block on which access to vital to quality medical, dental, and behavioral health care is rooted. Not only is it central to prevention, but it also reduces avoidable emergency room use. Through Open Enrollment, Central Texans can enroll in Marketplace plans that cover ten essential benefits such as primary care, mental health services emergency care, prescriptions—including birth control, and more. As part of our mission to advance health equity in Central Texas through investment and action, we remain committed to connecting Texans to free or low-cost quality health care coverage.
As Open Enrollment kicks off in Texas, it’s important to take a moment to recognize the significant progress that was made last year. With more than 1.8 million Texans signing up for health insurance coverage (including 500,000 who were uninsured the year before), it was a remarkable, record-breaking enrollment period.
Looking forward, what can we learn from last year’s seismic increase in enrolment as we work to close the uninsured gap in Texas? It’s clear—Texans want health insurance coverage. And, when it’s affordable and accessible, they’ll sign up. Last year, 94% of Texan enrollees saved about $470 a year on average because of financial assistance that helped lower the cost of premiums.
The good news is—financial assistance will continue to be available this year. And, just last month, the ‘family glitch’ was addressed, which means family members who may be eligible for employee-sponsored plans (but may not be able to afford the premiums) will now be able to receive federal subsidy support, as well. That’s an estimated 671,000 more Texans who will be eligible for financial assistance this year.
While recognizing the value of financial support, individuals and families have a lot to consider when looking at their options—including out-of-pocket costs, covered drugs, provider networks, and quality ratings of insurance companies. The free and unbiased help provided by many community organizations such as Foundation Communities, Light & Salt, CommUnityCare, Lonestar Circle of Care, among others across Central Texas last year was invaluable. The collective work of these organizations will continue this year and we appreciate the impactful work they lead in our community to connect our neighbors to health insurance, while shaping an equitable future for our Central Texas community.
We know individual insurance coverage brings immense and compounding health benefits that directly address social determinants of health. We also need to acknowledge the reality—despite the progress made to date, Texas continues to have the highest uninsured rate in the country with more than 20 percent of Texans still without insurance. Further, more than 770,000 of those people are ineligible for both Medicaid and premium subsidies given that Texas remains one of 12 states that has not yet expanded Medicaid under the Affordable Care Act, further exacerbating systemic inequities.
Connecting Central Texans with accessible and affordable health insurance coverage supports the health and well-being of individuals, their families, and their communities. For more information on the ACA Marketplace, Open Enrollment, and eligibility, check out this quick guide from HealthCare.gov, where you can also enroll in a plan.