5 Things Texas: Q&A w/Rep. Howard, Health in the budget, Impacts of Medicaid waiver rescission

Emily Boerger and Eli Kirshbaum collaborated to break the story on the CMS nullification of Texas’s 1115 waiver extension. We had some great reporting there, which we feature below.

We also tracked some big moments in the House as they thought about debating Medicaid expansion via a budget amendment. Or, at least we thought they were going to be big moments, right before the amendments were withdrawn. We dig into some of the amendments for you below so that you don’t have to spend the time watching the sausage of policy making get made.





With help from Emily Boerger

1. Implications of the Medicaid waiver rescission

Last month, CMS announced its decision to rescind the state’s Medicaid 1115 waiver extension, citing insufficient reasoning for exempting the state from the waiver’s required public comment period. I outline some of the implications of the rescission here.

In response to the sudden loss of funding, the Texas Republican Congressional Delegation called on the federal government to reverse the rescission entirely. Progressive voices, however, have insisted that now is the time to expand Medicaid to replace the waiver. During the House’s discussion on Texas’s budget in April, Rep. Coleman introduced an amendment to apply for a federal waiver which would “maximize” federal funds to increase health care coverage in the state. The amendment was rejected 80-68, but the chamber ultimately voted on an amendment requiring the state to reapply for the 1115 waiver.

2. Rep. Howard discusses reproductive health

Representative Donna Howard has served in the Texas Legislature for 14 years, working in numerous policy areas including women’s health and nursing policy. In this Q&A, Howard discusses her efforts to expand access to reproductive health care for Texas women, and dives into the details of her legislation to protect health care workers from workplace violence.

Howard says her bill that would eliminate numerous statutory restrictions to abortions is more about making “a major statement” in the midst of the majority party’s attempts to move toward more restrictions. “We are clearly in the minority in terms of votes in the Legislature, so it’s almost a fool’s errand to figure what can be done to really reverse some of the damage that’s been done. That doesn’t mean we won’t keep trying…”

3. 5 slides: Changing payment to support women’s health

Texas has some of the poorest health outcomes for maternal and newborn health in the nation. Can that be addresses by changing the payment structure? On Wednesday, May 12, from 12:00 – 1:00 pm CDT, we will host an impressive panel of experts to discuss the work being done to measure and address variations in maternal health, and to talk through how we can better connect payment models to improved outcomes.

At our “5 Slides: Changing payment to support women’s health” virtual conversation we’ll host Tami Hutchison, Senior Director, Episodes of Care at Signify Health, Andrea Balogh, Division President, Texas, at Women’s Health USA, and Ken Janda, Principal at Wild Blue Health Solutions. This event is free to attend, but you have to register to join us. You’ll be able to pose questions and participate in the conversation as well, just as you do in our conferences. So, we’d love to have you with us.


4. Last policy pushes of the legislative session

With just under a month to go until the 87th legislative session ends, lawmakers are busy at work trying to move their bills forward. Reps. Klick and Lucio III are sponsoring legislation to reduce fraudulent health insurance marketing practices. Rep. Coleman is spearheading an effort to establish a state Office for Health Equity. Some lawmakers are also pushing for policies allowing providers to refuse to treat patients for religious or moral reasons.

The “Healthy Families, Healthy Texas” plan, announced last month by House Speaker Dade Phelan, is a bipartisan package of bills legislators are promoting to increase health coverage for Texas families, mothers, and children. And, following a national trend this year, legislation restricting the rights of transgender Texans is prominent this session, with bills attempting to classify gender reassignment surgery as child abuse and prohibit doctors from performing such surgeries.


5. Health funding in the budget

The in-progress $246 billion Texas state budget for FY 2022-2023 contains a total of $87.2 billion ($34.3 billion general fund) in Article II Health and Human Services funding. Of that amount, about $80 billion is slated for HHSC and $1.8 billion is allocated to DSHS.

Among the health priorities in the budget is $352.6 million for women’s health programs, over $961 million for community mental health services for adults and children, and $496.2 million for substance abuse prevention, intervention, and treatment. The latest version of the budget comes after the House debated nearly 250 proposed amendments and ultimately voted the bill out of the chamber. The Senate has requested a conference committee and the 10 committee members were announced last week.