"Right now, we can get our patients in for discounted or even free services," says Bagwell. "For example, we work with agencies on breast health. [Our patients] are tied into the healthcare system through Los Barrios, we have the resources and collaborations to allow women to have testing and treatment. If this same woman has insurance, the options open to her are greater. We have great options, but with health insurance exchanges, it will ease up on the system."
Both Parkland Health & Hospital System, the Dallas-based safety net system and the American Hospital Association have questioned the Centers for Medicare & Medicaid Services about whether hospitals can pay premiums for patients who enroll in the HIXs.
The answer remains murky, as does the road to Medicaid expansion in Texas. Governor Rick Perry has held the line at a firm "no," despite outspoken opposition from providers.
"[HIX]is going to help some more of our indigent population, but there's some that will be left in a hole without Medicaid expansion," says Bramlett. "I hope that Texas decides to expand Medicaid."