Patient Advocates, Physicians and Medical Groups Unite Against Big Insurance

New Coalition Will Fight for Policy Solutions to Anti-Patient Insurance Practices

AUSTIN, Texas, Oct. 29, 2024 /PRNewswire/ -- Patient advocates, physicians and medical groups have joined together through the Texas Coalition for Patients (TCP) to demand common sense policy reforms that safeguard patients from Big Insurance tactics to delay and deny care.

"Navigating insurance often feels like a full-time job on top of being a full-time patient, mother, wife and employee," said Megan Koehler, a Texas heart transplant patient and cancer survivor whose insurance plan consistently denies coverage for treatment prescribed by her physician. "We're asking lawmakers to help Texas patients access the care their physicians prescribe without the Big Insurance hurdles that can imperil our health."

Big Insurance delaying and denying practices have an especially negative impact on the most vulnerable Texans, including low-income patients, racial minorities and those with cancer. The coalition will advocate for Texas lawmakers to enact policies to curb Big Insurance's influence over the state's health care system.

These problems are especially prevalent in rural communities. More than half of Texas rural hospitals with less than $40 million in expenses lose money on patients with private insurance. John Henderson, President and CEO of the Texas Organization of Rural & Community Hospitals (TORCH) said, "We have been forced to defend rural hospitals from coordinated attempts to undermine their value by organizations that put profits in front of patients."

Meanwhile, an astounding 93% of physicians say Big Insurance's prior authorization policies have had a somewhat or significant negative impact on patient clinical outcomes. Even more alarmingly, almost one in five (19%) report prior authorization delays have led to a patient's hospitalization. Fail First, another Big Insurance practice, requires patients who have been prescribed a medication to try a cheaper course of therapy first. If that fails, Big Insurance only then covers the medication originally prescribed by their physician. Although Texas lawmakers attempted to reform Fail First with S.B. 680 in 2017, these harmful policies continue to negatively impact patients.

"I will never forgive my insurance company for denying coverage for my daughter's physician-prescribed, life-saving medication until we took them to court," added Hailey Weihs, mother to Aniya Porter, who was born with a rare degenerative genetic disease called spinal muscular atrophy (SMA). "Every child in Texas deserves a chance to receive the medical care they need to live, grow and thrive."

Learn more about the Texas Coalition for Patients at TexasPatients.org. Current TCP members include The Livestrong Foundation, NAMI Texas (National Alliance on Mental Illness), the Texas Association of Neurological Surgeons (TANS), the Texas College of Emergency Physicians (TCEP), the Texas Hospital Association (THA), the Texas Medical Association (TMA), the Texas Orthopaedic Association (TOA) and the Texas Organization of Rural & Community Hospitals (TORCH) as well as various Texas physicians and patients. 

About Texas Coalition for Patients (TCP)
The Texas Coalition for Patients (TCP) works to support patients, families and health care providers who care for Texas communities by advocating for greater patient-centered transparency and accountability from all health care stakeholders. We are advocates from across the health sector and political spectrum working to give a voice to Texans by championing practices that put patients over profits. Learn more and join the fight to demand better coverage at TexasPatients.org.

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SOURCE Texas Coalition for Patients