5 Things TX: Anthony Haley, patient costs, AHCA

Just when you thought you could enjoy summer, it looks like we’re heading for both a special Texas legislative session and a US Senate vote on the AHCA in the weeks ahead. The sands are shifting under our feet.

Those two things and a few others are What We’re Watching in Texas health care in June

1.  Legislature wraps up, re-starts

According to the Texas Public Policy Foundation, there were fewer bills passed this session than during any legislative session since 1899.  The Center for Public Policy Priorities called it “one of the ugliest and least productive in recent memory.”  A deal on tele-medicine was among the health policy highlights. It calmed one of the more contentious issues in Texas health care.

Yesterday’s call by Gov. Abbot for a special session in July included 20 priority items, though health care reform was largely left off the list (extension of a maternity health task force made the cut). It’s unclear if and when the state will address further reforms to Medicaid or commercial insurance markets in light of anticipated Congressional action this year, a prospect reported to be increasingly likely (here, here).



2.  Video: Anthony Haley on health care politics

Anthony Haley spent more than 20 years in leading roles in the Texas Legislature, working with Texas Republicans, Democrats, and Supreme Court.  So, we’ve learned to listen to his pearls of wisdom.  He founded his own public affairs firm, HMWK, in 2005.

In this episode of “What They’re Watching,” Anthony sits down with us to talk about the over-politicization of health care and the challenges of providing care during a time of intense debate.  He thinks we need a “quieter environment” to talk through the challenges of an “overly politicized” issue in Texas politics today.


3.  Premium increases, costs to patients in 2018

The Century Foundation estimates that premiums will go up about $1,000 per year in Texas under the AHCA. The analysis is based on the recent CBO score showing 23m fewer insured under the proposed bill. The estimates assume, however, that the benefits required under the ACA remain in place. Those benefits could be diminished, theoretically, under a state waiver of some sort, which could mean a decrease in the insurance premiums in exchange for narrower benefits.

Narrower benefits could mean fewer providers would be required to be “in network” resulting in an increase to patients of surprise charges for services they otherwise believed were covered.  Gov. Abbott signed a new bill, SB 507, that creates a mediation process for consumers who see an out-of-network provider, and get a surprise bill in the mail. For example, 50% of ERs in Texas are already out of network. McAllen “has seen 89% surprise billing rates,” according to TAHP. Those numbers will likely increase if any of the ten essential health benefits under the ACA are waived in exchange for lower premiums.



4.  Podcasts: Jim Capretta, John Kitzhaber

I wanted to flag two podcasts for you that we’ve recently produced and which you might find interesting.

If you joined us for the 2017 Texas State of Reform Health Policy Conference in Austin, then you know Jim Capretta. He is the Milton Friedman Chair at the American Enterprise Institute, and a very savvy observer of health care policy and politics. You’ll recall he was one of our keynote speakers at the conference.

He joined the State of Reform Podcast recently to give us an update on the status of federal health reform.  We get into the weeds a bit – meaning he corrects me a few times where I’m wrong. But he also provides important historical perspective, like that President George W. Bush included funds in his budget every year for a pathway via tax credits to a broader coverage model.  It’s a wonky and worthwhile episode if you’re a policy geek.

We also released comments from former Oregon Governor John Kitzhaber.  He spoke at a recent event we held where he outlined how Medicaid could work efficiently under a per capita model, like that proposed in the AHCA.  For all of our podcasts, you can subscribe to us on iTunes.


5.  “Drunk donkey on roller skates”

It’s not often that health policy mixes easily with pop culture, but there have been two moments recently which provide an interesting window into how the rest of the world views the work of health policy leaders and health care executives.

First, Jimmy Kimmel’s monologue in May about his newborn son’s heart surgery was tear-jerking. As of this morning, the video has 23m views on Facebook, and 10m on YouTube.  Axios has a breakdown of the reach via social media and search (go to item #2).

Then, John Oliver took on dialysis at DaVita on his show on HBO (the headline quote is from Oliver). He points out that while 2% of the federal budget goes to the Dept of Education, 1% of the budget goes to kidney dialysis. Interestingly, our story on lawsuits facing DaVita from March has shot back up to be one of our most read stories across our entire site.