5 Things Texas: Election night, 2021 health policy preview, Delayed health care

There are a hundred reasons to stay busy today, to distract ourselves from this anxious time in our country. But, I’d encourage you to pause that for a bit, and to take stock of where we are as an American community.

It feels like one chapter is ending, and that – regardless of who wins – a different chapter is about to begin. So, I’d encourage you to have a conversation with your team or your family about this moment that we’re going through together. Reflect on it together, and share in it together. Don’t argue about which candidate is better or worse. Just listen to one another. Be there for one another. And appreciate the folks that make up your little community as we all go through Election Day together.

May our country be better off in 2021 than we have been in 2020.





With help from Michael Goldberg

1. What to watch on election night

If Texas House Democrats can add a net of nine seats, they will regain control of lower chamber for the first since 2002. There are 22 seats held by Republicans that Democrats hope they can flip and 12 Democratic seats that Republicans are targeting.

As Democrat MJ Hegar tries to pull off an upset victory over three-term incumbent, John Cornyn, there are 12 hotly-contested U.S. House seats on the ballot this year. Two of the seats, CD 7 and CD 32, are seats Republicans are attempting to take back after Democrats flipped them in 2018. The other 10 are held by the GOP. As for the state’s 38 electoral votes, FiveThirtyEight’s final forecast shows President Trump with a narrow lead, but within the margin of error.


2. Health policy preview for 2021

Over the course of two separate breakout sessions during the State of Reform Conference, legislators offered their observations on the health care and fiscal policy teed up for Texas’s 2021 legislative session. The Republicans said we can expect to see an effort to expand telemedicine and increase reimbursements to address provider shortages in rural areas.

Democrats said they are laser-focused on expanding Medicaid. In May of this year, 4.9 million Texans were uninsured – continuing Texas’s long-standing label of highest uninsured rate in the nation. Nearly 30% of non-elderly adults had a preexisting condition before COVID-19. As a result of these metrics, Democrats say increasing health care access through Medicaid expansion should be the foremost policy concern for legislators.

3. Baylor Alliance, Catalyst Health form partnership

The Baylor Scott & White Quality Alliance, which includes over 6,000 doctors and dozens of hospitals and facilities, is joining forces with the Catalyst Health Network, which has nearly 1,000 primary care doctors. Together, providers in the two groups care for about 1.75 million people.

The Baylor-Catalyst partnership will aim to offer more access and savings. The groups will also reach out to the state’s growing uninsured population. “It’s not just about expanding a network,” Baylor CEO Jim Hinton told the Dallas Morning News. “This is really around developing future products that don’t exist at scale in the DFW market.”

4. Report: 36% of Texans have skipped or postponed health care services

More than one third (36%) of Texans say they or someone in their household skipped or postponed health care services due to COVID-19, according to a report by Episcopal Health Foundation (EHF). The most commonly skipped visits were for preventative care like checkups, mammograms, colonoscopies and child immunizations.

Surprisingly, Texans with household incomes over $75K per year (44% of this demographic cohort) are more likely to say they have skipped or postponed care due to COVID-19. EHF says that this is likely due to differences in access to health care and health insurance coverage that preceded the pandemic.


5. One health policy change that should outlast Trump

Much of President Trump’s health policy agenda seems destined for reversal when he leaves office, either in 2021 or in 2025. But his push for greater price transparency might be the exception, writes State of Reform columnist Jim Capretta. The Trump effort is more ambitious in its reach that what came before it. It took a major step forward last week with the release of a final rule imposing sweeping new requirement on health insurers.

In addition to requirements forcing the posting of negotiated prices, the new rule allows insurers to reward plan enrollees with shared savings payments without running afoul of medical-loss ratio (MLR) requirements. Allowing consumers to share in the savings from use of low-priced services could be transformative and is the missing ingredient from previous efforts, Capretta writes.