In June 2021, Texas enacted House Bill 3924. The legislation, which took effect in September 2021, allows Texas Farm Bureau to sell medically underwritten health plans that will not be considered health insurance. This means that the plans are exempt from state and federal health insurance regulations.
The Texas Farm Bureau made these plans available as of mid-2022.
Since the plans are not subject to insurance rules, they are not required to cover essential health benefits, cap out-of-pocket costs, or provide guaranteed-issue coverage. H.B.3924 specifies that the plans cannot exclude a pre-existing condition for more than six months after a person enrolls. But the plans are allowed to charge applicants higher premiums based on their medical history, or reject the application altogether.
People who aren’t eligible to enroll in the Farm Bureau plans due to their medical history will still be able to sign up for ACA-compliant health insurance (through the Texas exchange or directly through an insurance company) during open enrollment or a special enrollment period. But consumer advocates worry that if healthy enrollees shift over to the Farm Bureau plans, they will leave the ACA-compliant risk pool with less healthy membership and thus higher premiums for everyone.