Texas & Medicaid | James Capretta | The ACA’s poisoned politics

While the holidays mean work life for many is slowing down, big challenges and opportunities are on the horizon for health care. So, here are 5 Things We’re Watching in Texas health care as we head into the heart of the holiday season.


 1. Texas’ Medicaid Opportunity

The selection of Seema Verma to head CMS indicates the Trump Administration is interested in providing great latitude to the states to design new, innovative approaches to the use of Medicaid dollars.  If Texas is interested, building a new approach to Medicaid using existing federal funds with more local control appears more available than ever under Verma.

Many in Texas health policy were already more focused on the 1115 waiver than on expansion, even before November 8. That existing waiver conversation could be a logical jumping off point for a bigger request to DC for more Medicaid flexiblity.

 2. Non-ACA issues will occupy legislators

Attention in the legislative session will be on more than the ACA and Medicaid.  Funding for rehabilitative services for medically fragile children is getting pre-session buzz, which could pit the Speaker against the Lt. Governor.  The “broken” foster care system is also a first tier legislative priority. A board of lawmakers released $150m in funds which included accountability measures.

Moreover, Sen. Charles Schwertner has filed a bill, SB 11, that includes comprehensive reforms to the Dept. of Family and Protective Services. Lt. Gov. Patrick has made the bill one of his top legislative priorities for the session, so expect movement there.

 3. James Capretta leads our conference agenda

We were thrilled to recently announce that James Capretta from the American Enterprise Institute will be the lunch keynote speaker as part of our conference agenda on February 8. In a recent Wall Street Journal column, Capretta laid out four principles that he believes should be part of the next health policy regime, which he has been arguing for in a way since 2012.

Capretta is a leading voice advising the incoming Trump Administration on health policy. Love that or hate it, he’s worth listening to in order to gain a better understanding of what’s to come from Washington, DC.  You can join him in Washington DC – or you can join us on Feb. 8th and hear from him in Austin.

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 4. Tom Price is who is he is: a specialty doc

Much has been written about Rep. Tom Price’s appointment to lead HHS in DC: he is anti-Obamacare and pro-consumer driven health plans. We watched 90 minutes of footage of Rep. Price talking about health policy. Here’s how we’d categorize his approach: he is a specialty physician who came up in leadership through his state medical association.

Price centers policy around the patient-physician relationship and believes that Congress has “an obligation to make certain that every American has healthcare.” He thinks that the primary cost drivers in health care are taxation and regulation. During those 90 minutes we watched, Price didn’t mention the words “pharma” or “pharmaceutical” once.

5. Will the post-ACA era improve health policy in Texas?

A common refrain from health care advocates in Texas is how the politics of the ACA have poisoned the ability to craft health policy.  One example is Rep. John Zerwas, whose past, unsuccessful attempt at using conservative approaches to reform and expand Medicaid was vilified as “Zerwascare.”  We’ve heard from policymakers and health care leaders who are quietly eager to move beyond the politicization – and there is hope.

Zerwas continues to be a pragmatic voice, for example. At a recent Texas Tribune event he offered thoughtful comments and cited the need for a “sound strategy” to ensure access to care after the ACA.  Will the pending demise of the ACA create new opportunities to find Texas-oriented solutions without the poison of Obamacare politics?  Maybe.  How enthusiastically leaders like Zerwas re-enter the fray will be one sign of movement.