Free Market Insurance Solutions Must Protect Texans

Hearing to Review Interim Charge 2: Health Insurance Market Stability Testimony of Ray Callas, MD

Senate Business and Commerce Committee

Jan. 24, 2018

Chairman Hancock and members of the Senate Business and Commerce Committee, thank you for allowing me to testify today on this interim charge.  

My name is Dr. Ray Callas. I am a practicing anesthesiologist from Beaumont, and today I am speaking on behalf of the Texas Medical Association and its more than 51,000 physicians and medical students.  

I would like to comment briefly regarding the exploration of allowing out-of-state insurance sales.

TMA does support free-market solutions to the business of health care; however, we want to ensure that patients receiving health care services also are protected.  

Should the legislature decide that allowing the sale of insurance across state lines is a viable option, we ask the following be taken into consideration:

  1. Products with in-network/out-of-network distinctions must meet Texas network adequacy standards. Texas has some of the best network adequacy provisions in the country, but they are only as strong as their enforcement. If a product is going to be sold to a consumer in Texas, we must make sure that the product meets the standard our state has put forth and it be enforced.
  2. Products must adhere to Texas prompt pay requirements. Out-of-state policies, if not regulated correctly, could undermine Texas payment laws that have been beneficial to both patients and physicians.
  3. Each company or HMO must meet minimum financial solvency standards required in Texas.
  4. The jurisdiction for legal challenges should not undermine the authority of the Texas Department of Insurance.

Overall, policies sold over state lines to Texans need to be regulated by the state of Texas to safeguard consumers and afford them the same protections and opportunities as they receive with Texas-based policies, such as our current mediation process for out-of-network balanced bills.

The legislature must be careful to not diminish its own oversight should this committee choose to proceed with legislation to allow insurance to be sold across state lines.

Again, TMA is supportive of free-market solutions to our state’s health care needs, but as a state we must ensure that patients are not only getting accountable care but also receiving an accountable health plan.

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Last Updated On

May 08, 2018