5 Things Texas: HHSC budgets, Dianne Longley, MCO accountability

With luck, we are nearing the home stretch for the 2019 legislative session. It’s one that saw more progress on health policy than some might have thought when we convened our Austin event in February. With the session almost done, and as we plan for our Dallas event in September, I’m sure we’ll still be sorting through the events from this session the next time we get together.

With help from Sara Gentzler
and Emily Viles.


1. Health care bills status update

There are just two and a half weeks until the end of this year’s legislative session. We’ve been tracking several health care-related bills over the last few months, and recently wrote an update on several of the health care bills that are still alive as the field of legislation narrows.

House bills 2454 and 2811, for example, establish new education requirements and regulations around prescribing opioids. Senate bills 307147, and 436 attempt to increase access to maternal health care. Other bills seek to expand access to care and reduce the high cost of pharmaceuticals.

2. Budget proposals: House vs. Senate

There’s a $3 billion difference between how the Texas House and Senate budget proposals fund Health and Human Services. After the Senate passed its version on April 9, the House refused to concur and a conference committee is now working toward a compromise.

Reporter Sara Gentzler details some of the specific differences in the proposals here. One big difference: The House proposal spends roughly $1 billion more than the Senate in its capital budget for HHSC, with $656 million of that difference going toward the construction of state hospitals and other inpatient mental health facilities. The chambers’ supplemental budget bills are much more similar in the funding they allot to HHS; however, the House proposal splits the funding among several efforts within the agency that the Senate doesn’t include.

3. Video: Dianne Longley, HMA

Dianne Longley is a Managing Principal at Health Management Associates. She joins us in this edition of “What They’re Watching” to discuss the social determinants of health.

“There are so many uninsured Texans that we still — even though we’ve made a lot of progress in recent years — we’re still trying to figure out how to spend our money and our time more effectively and get more people the type of care that they need.”


4. ‘Medicare for All’ and its price tag

Last week, the Medicare for All bill received its first Congressional hearing. The hearing, which attracted a great deal of partisan debate, discussed many of the unanswered questions regarding the shift from a patchwork, to a single-payer health care system. Reporter Emily Viles covered the hearing here.

Following the hearing, the Congressional Budget Office released a report suggesting the process of creating such a plan could be more difficult than originally anticipated. The report explained how a single-payer system could be constructed, how it could be paid for, and some of the challenges that lawmakers face in establishing rules and regulations for the Medicare for All model.


5. Digging deeper into managed care accountability

The issue of Medicaid Managed Care has deep roots in Texas. We have been tracking the issue from its beginning, and have been following many of the managed care and Medicaid reform bills introduced this session. The Managed Care Accountability bill is one of the most impactful.

The bill attempts to provide additional protections to disabled and low-income Texans, and to provide additional protections during the appeal process. Learn more about what the bill specifically addresses here.