5 Things Texas: US Rep. Michael Burgess, MFAR, Primary elections

Hosting State of Reform is a tremendous experience for us each year. Last week’s event in Austin with over 300 folks throughout the day was no exception.

So, thank you to those who have engaged and supported us over the years – who attend our events and read our stuff. We are honored you let us play this role in Texas health care.



With help from Emily Boerger and Madeline Shannon



1. Keynote: US Rep. Michael Burgess, MD

As the Ranking Member and former Chairman of the Subcommittee on Health in the House Energy and Commence Committee, Congressman Michael Burgess, M.D. has played an active role in many of the debates that have defined US health care over the past decade. At the 2020 Texas State of Reform Health Policy Conference in Austin last week, Rep. Burgess discussed the state of federal health policy and where he think it should go in 2020.

“If you look at the policies, such as the rules surrounding limited duration health insurance, that have come out of the White House since the individual mandate was zeroed out; my thesis is that this establishes a roadmap for us to follow on the legislative side if we really want to affect meaningful reform. Maybe not do it all in one big bill, but there are certainly pieces you can look at.”


2.  Primary election on March 3rd

Hundreds of people are vying for dozens of seats in the Texas Legislature during the March 3 primary, which also falls on Super Tuesday in the Democratic nomination context for President. Most of the legislative races will not attract much attention but there are a few worth watching where health care is an issue.

District 65 has both a Dem and Rep primary. Incumbent Rep. Michelle Beckley had 11 health care bills last session, a number she wants to increase in 2021. Chairman Garnett Coleman faces a few challengers in his Houston district he’s held since 1991, but is expected to hold that seat. Rep. Vikki Goodwin is making health care a central issue in her race for a seat she flipped in 2018 by 5,000 votes. She awaits the winner of a 5-person primary among Republicans.


3. MFAR comments and the impact on Texas

CMS’s proposed Medicaid Fiscal Accountability Regulation (MFAR) rule could have devastating impacts on rural health care and employment, according to comments released by the Texas Hospital Association, the Texas Organization of Rural & Community Hospitals (TORCH), and others. The MFAR rule would effectively end IGTs as a funding tool of Medicaid. IGTs are a central pillar of Texas Medicaid funding, which if lost have no clear replacement.

TORCH did not mince words, writing, “We believe there is no state more adversely impacted than Texas and no class of health care providers more acutely harmed than rural. Research repeatedly affirms that the closure of rural hospitals is a major contributing factor to rural infrastructure loss, rural employment loss, a decline in preventative care and a decline in access to primary and emergency services.”


4. What you missed at State of Reform

Last week we hosted the 2020 Texas State of Reform Health Policy Conference, bringing together over 300 attendees from across Texas’s health care ecosystem. If you weren’t able to make it to the conference, don’t worry, we’ve got you covered. You can check out this highlight video from the conference to get a feel for the sights and sounds of the event.

You can also catch the bipartisan keynote conversation with Sen. Nathan Johnson and Rep. Stephanie Klick as they talk through state policy making. Finally, the inimitable Colm O’Comartun rounded out the day with us, talking through the demographic changes that underpin the conversations about health policy in the race for Democratic nomination for President.


5. Capretta: “Healthy Adult Opportunity” initiative

Some of the biggest health news in recent weeks came from CMS’s release of the “Healthy Adult Opportunity” initiative, or what many are calling a “block grant” model. Our State of Reform columnist Jim Capretta of the AEI breaks down the new proposal. He takes a complex proposal and explains the impact and its component parts.

Some critics suggest that the new waivers will lead to a downsizing in Medicaid, but Capretta says this only happen if states that have already expanded Medicaid choose to submit waivers. “It seems more likely that the governors who will be most attracted to the new option will be those who serve in states that have not yet expanded their Medicaid programs,” writes Capretta. “If this waiver program entices several non-expansion states to join the ranks of those that have expanded their programs, then it is possible the administration’s proposal will increase enrollment in Medicaid rather than reduce it.