5 Things Texas: Pre-filed bills, Rep. John Zerwas, vaccine legislation

The legislature still doesn’t start for two months, but things are already moving.  Pre-filed legislation is out, as are rider reports from the last session budget.  There is even a comical faux Twitter account for projected-to-be-new Speaker Dennis Bonnen.

With things afoot in Austin, we’re also gearing up for our 2019 Texas State of Reform Health Policy Conference!  Our early bird rates are still up, if you’re interested in joining us on Feb. 5th!

DJ 5 Things Signature


With help from Marjie High, Sara Gentzler,
and Emily Boerger.


1. Pre-filed bills out this week for #86thLege

In two days, there were 45 bills pre-filed related to health or health care. Given how early these are, they are usually either straightforward and likely to move easily.  Or, they are political statements, markers in a broader political conversation.

HB 282 would allow any county wishing to expand Medicaid eligibility to be able to do so.  I read the bill to allow local IGT or county dollars to cover the state portion of the Medicaid rates.  That’s something local jurisdictions are very good at figuring out, if they want to.  HB 220 wants to make Medicaid reimbursement “comparable to prevailing market rates.”  This would be a significant hit to the budget, I’m guessing, but it might garner some early support before a full fiscal analysis can be done.


2.  Convening Panel shaping 2019 conference

Last week, our Convening Panel met to launch our agenda setting process for our upcoming 2019 Texas State of Reform Health Policy Conference. It was a great conversation of diverse voices who shared what topics in health care and health policy in Texas are capturing their attention.

We’re taking their ideas and creating our Topical Agenda, which will be released in three weeks. If you have any ideas for topics or speakers on key health care issues of the day, drop me a note and let me know. And if you want to join us on February 5th, register now to take advantage of our early bird rate.  That rate goes up late next week.

3.  Look out for vaccine-related policy discussions next session

Two vaccine-related legislative reports from the Texas Department of State Health Services will inform policy discussions during the 2019 session. To sum up the two reports: Texas vaccination rates were mostly on-par with the rest of the country as of 2016. However, 1.07 percent of Texas students have a conscientious exemption on file, and that number has gone up by almost 19 percent in the last year.

At least one conversation around conscientious exemptions looks like it’ll be a holdover from the 2017 legislative session: State Rep. J.D. Sheffield, who is also a family physician, will reportedly re-file a bill he proposed that would yield more transparent reports on vaccine exemptions and vaccine-preventable disease rates. Likely, the bill will again face opposition from anti-vaccination groups — Texans for Vaccine Choice calls it a “dangerous bill.”


4.  Video: Representative John Zerwas, MD

Representative John Zerwas, MD was the Chairman of the Texas House Appropriations Committee for the 2017-2018 biennium and a is a practicing physician. He joined us earlier this year to tape this edition of “What They’re Watching” to talk about value based care.

“We’re still very much a ‘sick care’ sort of mentality in terms of health care because frankly, what drives the economy are the kinds of things we do ‘sick care.”  This is not something that you say overnight – that you’re going to start doing population health and that’s going to be the remedy to our health care issues. It’s going to have to be something that says, ‘How do I as a health care provider, who currently is making money by people that come in sick and take care of them,’ versus ‘How do I make money as a health care provider by helping people stay well?'”

Now that Rep. Zerwas is out of the race for Speaker, watch to see where he lands in committee leadership for the next session.


5. Updates proposed to the Texas State Health Plan

The Texas Statewide Health Coordinating Council (SHCC) recently submitted its 2019-2020 update to the Texas State Health Plan at the beginning of November. The update builds on the 2017-2022 State Health Plan which focuses largely on supporting primary and mental health care in the state.

The new update includes recommendations to the legislature for the upcoming session on improving Texas’s health literacy, increasing the availability of clinical training sites, and addressing the state’s oral health needs.  It also addresses improving Texans’ access to trauma care. You can read our rundown of the key takeaways from the report here.