• Affordable Care Act Resource Center

    • TMA Takes on Marketplace Madness

      Confused by all you’ve heard about the Affordable Care Act marketplace insurance plans? Do you know whether you’re in — or out — of the narrow networks? How will you tell if a patient is on an exchange plan? What happens to you if patients don’t make their premium payments? What, if anything, can you do about all of this? TMA answers these and other tough marketplace exchange questions. Updated: December 2015. MembersOnlyRed
  • 2016 Texas Exchange Markets

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  • Affordable Care Act in the News

    • Congressional Leaders to Highlight Border Health Conference
      Physician leaders from Texas will meet in El Paso with federal legislators and government officials to discuss critical health care needs and challenges facing communities along the U.S.-Mexico border. The 10th Annual Border Health Conference is sponsored by Texas Medical Association’s (TMA’s) Border Health Caucus (BHC). BHC’s mission is to ensure access to care for all patients along the border. 
    • ID ACA Exchange Plans on Insurance ID Cards
      HB 1514 testimony of Sara Austin, MD, before Senate Business and Commerce Committee, May 14, 2015
    • TMA: Identify ACA Plans on ID Cards
      Texas physicians are glad to have more of their patients covered through the ACA marketplace. But that new coverage compounds and highlights the many administrative challenges that physicians and their staff have experienced even before the marketplace existed. Some of the marketplace issues and challenges are:
    • Agency Went Too Far; and Painkiller Change Is a Pain
      This month’s Texas Medical Association’s (TMA’s) Texas Medicine magazine, featuring a legislative preview, is packed with health care stories, including these: Texas’ Sunset Advisory Commission said the agency investigating potential Medicaid fraud overreached its charge; expanding health insurance coverage would help the working poor; lessons learned from the Ebola crisis; the impact of reclassifying a popular painkiller; and a year after implementing the federal insurance marketplace, what trends are emerging? 
    • Minding the Gap
      Texas chose not to expand Medicaid eligibility in 2014 under the Affordable Care Act, leaving more than 1 million uninsured Texans in the coverage gap. Now that several states have succeeded in finding alternative solutions to cover the working poor without expanding Medicaid, some lawmakers are optimistic Texas, too, can develop its own unique plan to draw down the roughly $100 billion in federal funding available over 10 years.
    • Smoother Sailing?
      As medical practices prepare to adjust and help care for the newly insured in round two of the Affordable Care Act marketplace, some uncertainties linger. The Centers for Medicare & Medicaid Services says it ramped up outreach efforts and largely smoothed out the technical problems from last year that complicated not only patients' enrollment through healthcare.gov, but also physicians' ability to track their coverage. Still, the prevalence of high-deductible plans and "narrow" networks that limit the doctors and hospitals patients can use contribute to persistent concerns over access to care.
    • How ACA Exchanges Impacted Physicians and Their Patients
      The ACA brought both challenging administrative changes and decisions that must be made. Texas physicians were glad to have more of their patients covered, but that new coverage compounds and highlights the many administrative challenges that physicians and their staff currently experience with their existing patients covered by commercial and government programs today.
  • Hot Topics

    • What Qualified Health Plans are Operating on the Marketplace in My County This Year?
      As of Dec. 15, 2015, there were 19 insurance companies offering 543 different qualified health plans on the Affordable Care Act marketplace exchange in Texas for 2016. Each plan is offered on a county-by-county basis. Here is the list of plans, sorted by county.
    • PPACA Employer Mandate Delayed
      Physicians who have 50 or more employees have another year to comply with the "employer mandate" of the Patient Protection and Affordable Care Act (PPACA). The law requires employers with 50 or more employees to offer health insurance coverage or pay a penalty.
    • Find It, Fix It, Keep It: Patient Protection and Affordable Care Act
      Patient Protection and Affordable Care Act: Find What’s Missing. Keep What Works. Fix What’s Broken.
    • TMA: Don't Make Docs Pay For Inaccurate Plan Directories
      Calling it either "an enormously unfortunate oversight" or "a government grab at discount health care services," TMA is vehemently opposing a new federal policy regarding physician participation in the Affordable Care Act exchange marketplace health plans. 
    • Marketplace Means Decision for Doctors
      The opening of the health insurance marketplaces under the Affordable Care Act (ACA) on Jan.1 means you must be vigilant in your dealings with the health insurance companies. Or you could face major problems.
    • ACA: From Theory to Boots on the Ground
      New report from the Physicians Foundation examines the implementation of key provisions – in particular the health insurance exchanges – and ongoing challenges of health reform. It is the first installment in a series of reports on ACA coverage expansion and key mandates.
  • TMA Help for You to Survive and Thrive in the New Health Care Landscape

  • Congressman Mike Burgess, MD: The Case Against the ACA

    The Case Against Obamacare from texastribune on Vimeo.

    "The Case Against Obamacare" panel with U.S. Rep. Michael Burgess moderated by Scott Braddock at The Texas Tribune Festival September 24, 2011.

  • Full Text and Analysis of the Patient Protection and Affordable Care Act

    • Read the Full Text

      Read the entire bill, amendments, official summary, and legislative history at Congress.Org
    • TMA's Health Reform Bill Executive Summary

      Prepared by TMA experts, this analysis reviews what the bill does and does not do.
    • TMA Complete Summary

      Use this TMA staff summary of the bill and amendments to find which provision of the law may pertain to a particular question or issue. Then turn to the full text.
    • TMA Guiding Principles

      House of Delegates' guiding principles TMA followed as it made Texas physicians' voices heard in Washington during the debate.