Doctors think insurance cards in Texas that identify HIX enrollees could serve as a reminder to pay their monthly premiums and reduce the number of unpaid bills. Critics, however, counter that they are akin to a Scarlet letter and could be used to deny treatment. They also question whether they will actually produce anything useful, since it doesn’t indicate whether plan participants are delinquent on their premiums.

Texas House Bill 1514 sought “a uniform way” to distinguish which patients are covered under the Affordable Care Act or by a qualified health plan (QHP), according to a legislative analysis. There also was a controversial effort to identify which of the 1.2 million state residents who signed up for coverage through Healthcare.gov receive federal subsidies, which the U.S. Department of Health and Human Services estimates at 85%, but that plan was later dropped.

Under the bill, which passed the Senate in late May and was signed by Republican Gov. Greg Abbott in mid-June, the “QHP” acronym will be added to the insurance cards of HIX enrollees. Authored by GOP State Rep. J.D. Sheffield and sponsored in the Senate by Republican Sen. Brandon Creighton, it will take effect September 1.

Also see: More accurate HIX provider directories sought

An earlier version that proposed a “QHP-S” designation for those who receive subsidies was blasted by critics, including the Rev. Al Sharpton, who called both labels “absurd” and feared that doctors and hospitals alike could exploit a HIX identification to turn away patients that may have trouble paying their bills. The Texas Association of Health Plans also had expressed concern about HIX coverage labeling being used to deny care.

Supporters of House Bill 1514 include the Texas Medical Association, Texas Hospital Association, Texas Academy of Family Physicians and other trade groups. 

Neurologist Sara Austin testified before the Texas House Committee on Insurance that the QHP acronym on insurance cards represents an “opportunity to stress the importance of continuing to pay their portion of the premium that is not subsidized by the federal government.”

She said the label also could reduce provider collections on unpaid bills, though a recent article in the Tampa Bay Times suggested that doctors and hospitals always could seek reimbursements from insurance companies that are required to alert them to “a possibility that claims might be denied because the patient is in the second or third month of the grace period.”

Also see: 8 public exchange states see ‘reassuring’ premium increases

But Sabrina Corlette, director of Georgetown University’s Center on Health Insurance Reforms, told the newspaper she doubts House Bill 1514 will serve any practical purpose because providers cannot tell from the new insurance cards “whether the patient is actually in the grace period” or eligible for a subsidy.

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