Texas Cares
Introducing…
Vikki Goodwin’s Texas Cares Plan creates a new, state administered health insurance program to cover low-income Texans, working Texans, and Texans who remain uninsured after pursuing coverage through their work, the marketplace, and family. There’s an option for everyone.
3 Tiers to Cover All Texans
The Texas Cares Plan will create coverage options for the 5.1 million Texans who are currently uninsured.
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Available to Texans up to 138% of FPL
Medicaid Expansion extends comprehensive health coverage to low-income Texans by drawing down available federal funding, ensuring affordable access to care while reducing the state's uninsured population.
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Available to Texans from 138-200% of FPL
Lone Star Basic provides affordable, state-administered coverage for working Texans who earn too much for Medicaid but still struggle to afford private insurance. By leveraging federal Basic Health Program funding, it bridges the gap between Medicaid and the individual marketplace.
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Available to all Texans
Lone Star Preferred is a state-run, state-funded health insurance option that provides an affordable and accessible alternative to the individual market.
Texans pay into health insurance with the expectation that their coverage will be there when they need it, but too often patients and providers are left fighting over what insurance will actually cover.
As the first state-run program of its kind, Lone Star Preferred will make decisions about payments and coverage based on what's best for patients, not what maximizes profits.
The program offers enrollment assistance and care navigation support. It focuses on keeping people healthy before they get sick and prioritizes covering children first.
Premiums would be scaled according to income, ensuring that cost is proportionate with what each participant can afford. To maintain lower monthly premiums, participants would be encouraged to complete routine preventative care.
Preventative and Step-Down Care:
Lone Star Preferred will prioritize getting Texans into the healthcare system before a health problem becomes an emergency by making preventative and diagnostic care easier to access. To encourage routine preventative care, Texans who receive an annual checkup would pay no copay or deductible for the visit, with appropriate bloodwork and recommended screenings to help identify and treat serious conditions earlier, when treatment is often more effective and less costly.
Preventative care is also critical to improving maternal health. The program will prioritize early and continuous prenatal care to identify potential complications sooner and reduce preventable maternal health risks, with an emphasis on improving outcomes for Black women in Texas, who continue to experience disproportionately poor maternal health outcomes.
Lone Star Preferred will strengthen step-down care so patients are not left without appropriate care after leaving the hospital. The program will improve transitions from hospital-level treatment to rehabilitation, home-based care, and other appropriate services, helping patients recover while reducing preventable readmissions and unnecessary healthcare costs.
Workforce and Access:
Expanding health coverage only works if Texans can access providers when they need them. Lone Star Preferred will address provider shortages and strengthen access to primary care, specialists, and other healthcare services across rural and urban communities.
Lone Star Preferred will support competitive reimbursement rates for primary care providers to strengthen provider participation and ensure Texans have meaningful access to routine and preventative care.
Cost and Funding Mechanisms:
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Cost: The program's cost will primarily depend on how many people enroll and what health services they use. Administrative costs will scale with enrollment but should remain a relatively small portion of the total budget.
Funding Mechanisms: Funded through Medicaid expansion financing, with the federal government covering 90% of all health expenses and the state covering the remaining 10% plus administrative costs.
Since Texas hasn't expanded Medicaid, it has missed out on approximately $10 billion in federal funding each year, according to Cover Texas Now. Since 2014, that adds up to over $100 billion in lost federal support. This program would finally tap into that available federal funding.
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Cost: The program's cost will primarily depend on how many people enroll and what health services they use. Administrative costs will scale with enrollment but should remain a relatively small portion of the total budget.
Funding Mechanisms: Federal payments would finance most of Lone Star Basic. Currently, federal dollars flow to insurers to lower the cost of Marketplace coverage for eligible Texans. Under Lone Star Basic, 95% of the federal funding that would have gone to private insurers would instead go to Texas to help fund the program. A Texas-specific actuarial analysis would determine the total federal payment based on enrollment projections. The state would cover any remaining program costs and administrative expenses.
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Cost: The overall cost of Lone Star Preferred would depend on the number of individuals enrolled, the cost of providing health care services, and administrative resources required to operate the program.
Funding Mechanisms: Lone Star Preferred will be funded through a one-time payment from the Rainy Day Fund (the state's emergency savings fund), along with ongoing revenue from a new tax on legal cannabis. This money covers the initial setup and operating costs, and builds a financial cushion to keep the program stable. Once that period ends, the program becomes self-sustaining through member premiums and cannabis tax revenue going into the fund.
The proposed state tax on cannabis sales will be deposited into the Texas Healthcare Fund to finance Lone Star Preferred going forward. This revenue is dedicated exclusively to health coverage, preventive care, and program administration. Based on recent analysis, Texas could generate a dedicated funding stream with a potential to generate an estimated $267.7 million in sales tax revenue for the state.
Don’t miss the East Texas Healthcare Tour August 18 — August 23.
Tell Vikki Your Healthcare Story…
Rep. Goodwin is running for Lieutenant Governor to make Texas more affordable — and top of her list is healthcare.
Share your healthcare story to help her understand the many healthcare challenges Texans are facing…