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Zika Reminder: Mosquito Repellent Covered Under Medicaid - 09/06/2023

To protect against Zika, mosquito repellent prescriptions are covered through Medicaid and other state programs, including the Children’s Health Insurance Program.

TMA Asks AMA to Stay Out of Affordable Care Act Suit - 05/02/2023

Leaders of the Texas Medical Association on Tuesday publicly objected to the American Medical Association’s plans to get involved in a high-profile federal lawsuit — filed in Texas — challenging the constitutionality of the Affordable Care Act.

Texas Children Among Most at Risk of Losing Health Coverage When PHE Ends - 08/19/2022

Texas is one of six states where children enrolled in Medicaid and in the Children’s Health Insurance Program are especially at risk of losing their health insurance when the public health emergency ends.

Private Health Plans Must Cover Women’s Obesity Counseling, Other Preventive Services - 04/05/2022

Starting next year, private health plan policies that began after the Affordable Care Act (ACA) went into effect now will have to cover multiple types of prevention counseling for women, as well as contraceptive care, double electric breast pumps, and more.

Bolster Medicaid and CHIP Enrollment With These Grants - 04/05/2022

Organizations interested in increasing access to Medicaid and Children’s Health Insurance Program (CHIP) coverage can apply for up to $1.5 million each after the Centers for Medicare & Medicaid Services (CMS)  announced on Jan. 27 that it was committing more than $49 million in federal grants to the Biden administration’s effort to “fund organizations that can connect more eligible children, parents, and pregnant individuals to health care coverage.”

Tell Your Uninsured Patients About HealthCare.gov Marketplace Enrollment - 11/19/2021

Enrollment in the federal health insurance marketplace on HealthCare.gov is now open, so it’s a good idea to let your uninsured patients know the option is there. And if they sign up by Dec. 15, their coverage will begin at the start of 2022.

Enrollment for Marketplace Plans Extended by One Month - 09/24/2021

The Biden-Harris administration has announced a 30-day extension of the upcoming open enrollment period for federal marketplace health plans available through HealthCare.gov, as well as a new monthly special enrollment period targeting people with low incomes.

Remind Uninsured Patients: ACA Enrollment Ends Aug. 15 - 07/21/2021

The Texas Medical Association encourages physicians to remind uninsured patients to take advantage of the Affordable Care Act’s (ACA) Special Enrollment Period , which has been extended to Aug. 15 in response to the COVID-19 pandemic.

CMS Finalizes Lower-Than-Proposed Cost-Sharing for Marketplace Plans; Enrollment Closes Aug. 15 - 06/17/2021

The Centers for Medicare & Medicaid Services (CMS) has settled on a lower maximum for consumers’ out-of-pocket costs for federal health insurance marketplace plans in 2022 than what the agency proposed last November.

CMS Working to Improve Enrollment in ACA Marketplace Health Plans - 04/26/2021

More federal resources will be available next year to help uninsured Texans gain access to health coverage through the Affordable Care Act (ACA), the Centers for Medicare & Medicaid Services said last week.

Five Simple Things You Can Do for Your Practice - 01/14/2021

The only way for you to effect "real change" is through the legislative process. Here are five simple things you can do for your practice starting today - right at your desk.

Portal to Apply for Medicaid and CHIP Relief Funds Open - 06/11/2020

The Department of Health and Human Services (HHS) has opened a portal for physicians who treat Medicaid and CHIP patients to apply for federal emergency assistance related to COVID-19.

Texas Doctors: Protect Patients’ Access to Care From Budget Cuts - 06/04/2020

The Texas Medical Association (TMA) and several other health organizations are urging state leaders to protect patient access to care by taking essential health care services off the financial chopping block.

Open Enrollment 2020: Be Prepared for Coverage Changes - 11/13/2019

You’re probably already aware that open enrollment for commercial health insurance plans, including those on the Affordable Care Act Exchanges, opened Nov. 1 and will run through Dec. 15. While some patients won’t make any changes to their coverage, others will make significant changes, including enrolling with a completely different health plan.

Texas Continues to Lead Nation in Uninsured Adults and Kids - 09/30/2019

As of 2018, 11.2% of Texas children younger than 19 were uninsured, up from 10.7% in 2017, according to data the Census Bureau released last week. All told, Texas has led the nation in uninsured residents over the past two years, Census data show.

Raise Taxes on Vape Products to Decrease Youth Usage - 04/09/2019

HB 4013 and HB 3364 would deposit tax revenues to the state’s general revenue fund, while HB 1144 directs tax revenues to the Children’s Health Insurance Program (CHIP). Evidence shows more smokers favor tobacco taxes when they are not a general revenue raising tool – in a study of current smokers, only 25% favored increasing taxes on cigarettes, but support climbed to 60% if taxes funded health care programs.

ACA Ruling An Opportunity to Improve Health Care Access - 12/19/2018

The Texas Medical Association believes a Texas federal judge’s recent ruling that the Affordable Care Act (ACA) is unconstitutional provides a bipartisan pathway to strengthen access to health care and provide coverage for the 4.5 million Texans without health care coverage.

Webinar Can Help You Clear Medicaid Telemedicine Static - 10/12/2018

Do you understand telemedicine in Texas, particularly when treating Medicaid patients? If not, you might want to register for a live, free webinar on telemedicine and telehealth services scheduled for the end of October.

When Patients Don’t Pay Their Premiums in the ACA Marketplace - 04/17/2018

Will physicians have to refund payments to an insurer if a patient who bought coverage from that insurer in the Affordable Care Act marketplace doesn’t pay his or her premiums?

Congress Votes to End Shutdown, Provide Long-Term CHIP Funding - 01/22/2018

Lawmakers approved a short-term spending package Monday that would fund the federal government through Feb. 8 and end a three-day government shutdown. The package also will extend the Children’s Health Insurance Program (CHIP) for six years, according to several media reports.

Analysts: Ending ACA Cost-Sharing Payments to Affect Middle Class - 12/05/2017

The Trump administration made a splash in October by announcing an end to government subsidies that help insurers provide discounts to low-income enrollees in the Affordable Health Care (ACA) marketplace. However, analysts say it won't be low-income people who will feel a financial hit from President Donald Trump's decision on the cost-sharing reduction (CSR) payments. Instead, people with higher incomes pick up the tab, analysts said.

Purchasing Insurance Across State Lines - 05/25/2017

The Affordable Care Act, signed by the President in 2010, actually provides for the sale of health insurance across state lines. States may form interstate compacts that would allow states in those compacts to sell qualified health plans to purchasers in other states in the compact.

Can I Pay My Patient’s ACA Premium to Ensure Coverage? - 03/30/2017

If I receive notice that patients who are covered by a health plan in the Affordable Care Act exchange are within the three-month grace period for paying their premiums, may I just pay their premiums to make sure they have coverage while I provide services?

Health Care Coverage for Low-Income Texans - 02/03/2017

Medicaid and the Children’s Health Insurance Program (CHIP) cover more than 4 million low-income Texans. That includes half of all children in the state and about two-thirds of people in nursing homes. As the Texas Medical Association has long cautioned, however, a Medicaid card does not equal access to health care. Extremely poor payment rates and extraordinarily high bureaucratic burdens lead most Texas physicians either to refuse to accept all new Medicaid patients or to limit the numbers they can see. TMA encourages the Texas Legislature to increase Medicaid and CHIP payments and reduce administrative hassles, and to search for creative new ways to provide more health insurance coverage for low-income Texans.