Freestanding ERs | Geronimo Rodriguez | Mental health

I’m taking over for Eric this month as your loyal scribe.  So, go easy on me!

Setting aside the Republicans’ health reform bill in DC has diminished predictability rather than added to it.  In Austin, most of the attention is on closing the remaining gaps in the state budget between the House and the Senate. Yet, there are some significant health care issues still brewing, including freestanding ERs, mental health, and more.  And, they are on our list of 5 Things We’re Watching in Texas health care for April.

1.  The current health care costs whipping boy

There has been a battle brewing in Austin between freestanding ERs and a unique coalition of other health care players. Senator Kelly Hancock’s SB 507 on balance billing is in part a response to this within the context of rising health care costs. The bill appears headed to the Governor’s desk by the end of this session.

That bill is part of a bigger push by insurers, the business community, and consumer advocates (more coverage here and here), with the freestanding ERs fighting back. Whatever the legislative outcome, it’s clear from talking to stakeholders – including in Dallas-Fort Worth, with its huge concentration of freestanding ERs – that this is but the latest symptom of the persistently unsolved problem of rising health care costs.

2.  Video: Geronimo Rodriguez, Seton Healthcare

Geronimo Rodriguez is the Vice President of Advocacy and External Affairs at the Seton Healthcare Family. In this episode of What They’re Watching, he talks about Texas working with the Trump Administration, including on the 1115 Waiver. He also argues for expanding nursing education to add to the pool of providers to serve Texas’ growing population.

On Medicaid, he argues there’s an opportunity to influence the conversation so policymakers understand the impact of health policy changes on Texans: “I think Medicaid reform is really important…making sure we have a mindfulness about the poor and the vulnerable and taking care of them.”

3.  What’s next for the ACA in Congress?

The ACA was supposed to be a dead man walking after President Trump took office with a GOP Congress. That hasn’t turned out to be the case. We’ve thought for a while that “repeal and replace” would be tougher than people expected. Both the politics and the policy made a Republican consensus difficult. That proved to be true when the AHCA went down in flames without so much as a vote.

While many in the GOP are interested in living up to their campaign promises, we think there are some gaps in understanding of health care policy for some Republicans that further complicate a path forward. In the meantime, states might be better served leaping on the opportunity for flexibility and innovation from HHS.

4.  Mental health taking shape in the Legislature

For all the battles in Austin around the budget and other issues outside of health care, one health policy issue is quietly moving forward. Indeed, “mental health reform has a chance at success” as Rep. Four Price’s HB 10 on mental health parity acts on the recommendations of the House Select Committee on Mental Health, which Price chaired.

House Speaker Joe Straus has both lauded the Committee’s work and supported $162 million in funding to address some of its findings. Amidst all the partisanship on so many issues in today’s politics, the bipartisan tone from Price and Rep. Joe Moody at a Texas Tribune event on the topic earlier in the session was a notable indicator of the potential in taking steps to address the bigger societal challenge of improving mental health care.

5.  Launching the State of  Reform podcast

State of Reform tries to bridge the gap between the world of health care and that of health policy.  We do this in part by providing a platform for the voices of senior executives and health policy leaders.  The content generated by them is then shared across multiple information channels, providing insights wherever consumers access their information: web, email, social, video, small-run book publishing, and conferences.  Last month, we added a podcast to that list.

In our first podcast episode, we talked to people in the Lone Star State, perhaps the staunchest state-opponent to the Affordable Care Act.  We wondered: Is a Trump presidency good news for Texas health care?  We asked that question before the rise and fall of the AHCA. But, we think the acute anxiety we heard when recording this podcast is probably just as palpable today.