Senator Eliot Shapleigh - El Paso, Texas

They say everything's bigger and better in Texas, and it's true that Texans have a lot to be proud of, but the Lone Star State has a lot of catching up to do when it comes to providing affordable health coverage. Statistics show that Texas has the highest uninsured rate in the nation. More than 5.59 million Texans — nearly 25 percent of our total population — lack basic health coverage. That's nothing to brag about.

In 2003, with an eye toward improving those statistics, the Texas Health Institute launched the "Shared Vision for Healthcare in Texas" project. We enlisted the aid of six stakeholder groups with varying perspectives — business, community leaders, consumers, government, insurance and providers — to produce consensus-driven solutions to achieve quality, access and cost-effectiveness for healthcare in Texas.

On Jan. 31, the institute released the findings of its comprehensive study in a report called "A Vision for Change: Policy Solutions for Increasing Health Coverage in Texas."

The "Shared Vision" report presented 12 practical policy solutions for the consideration of the Legislature. Many proposals require only a modest amount of state funding. When combined, they could cut the number of Texans without health coverage almost in half. They could help almost 2.7 million Texans obtain coverage. And they could bring more than $1.7 billion in federal funds to the state.

With just weeks left in the legislative session, the time to enact solutions is now. Several pieces of legislation still hold promise:

• Providing technical assistance and seed funding for public-private, cost-sharing, pilot health access programs (Senate Bill 10 and SB 922)

• Expanding the use of the Medicaid Health Insurance Premium Program, encouraging employer participation by reducing premium costs and making coverage more available for individuals with health conditions and low-income citizens (SB 10)

• Enacting employer tax credits (House Bill 2777)

• Expanding eligibility for Texas' Insurance Health Risk Pool (SB 1254)

• Persuading young adults to obtain health coverage through colleges and universities (HB 3321)

• Fully restoring the Children's Health Insurance Program (HB 109)

• Aligning Medicaid and CHIP renewal policies (SB 266)

The institute's vision emphasizes access for all. It calls for a more rational system than emergency room care for serving the healthcare needs of the uninsured. And it promotes sound use of health care resources, public and private.

Texans are already paying for the uninsured. In Texas and the nation, the uninsured pay only one-third of the cost of health care services delivered to them annually. The government and privately insured people pay the rest. Insurance premiums for Texans are about $1,550 higher because of the cost of caring for uninsured patients.

The institute's "Vision for Change" presents a comprehensive, viable plan for improving health care access while using resources efficiently and bolstering the state's economy. Grounded in common sense, fact and consensus, the proposal represents an extraordinary opportunity to bring Texas to the forefront of health care among the 50 states — where we belong.

If the Legislature enacts the bills into law this session, the members of the Texas Senate and House will have taken a significant step toward reducing the overwhelming number of uninsured Texans.

Now that would be something to brag about.

Miller is president and CEO of the Texas Health Institute, a nonprofit, nonpartisan think tank working to improve the health of Texans and their communities.