This newsletter features a video of the Lunch Keynote from last month’s 2022 Texas State of Reform Health Policy Conference as well as updates on Medicaid financing and important health policy litigation.
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State of Reform
1. Lunch Keynote: Health policy in the Texas Legislature
Two high-profile leaders in health policymaking took the stage during the Lunch Keynote at our conference last month. Rep. Chris Turner, Chair of the House Democratic Caucus, and Rep. James Frank, Chair of the House Human Services Committee, discussed the policy that came out of last year’s legislative session, efforts to increase health care coverage, and their interim work.
Turner’s comments focused on Medicaid expansion, health equity, and the causes of high health care costs. Frank discussed price transparency, increasing competition for health care coverage, and prescription drug policy. Watch the full conversation on our site.
2. Hospital funding restored through 1115 waiver
On March 25th, CMS restored federal funding to Texas hospitals that was withheld in September after the federal government raised concerns over the legality of the Local Provider Participation Fund. The LPFF, in which local private hospitals supplement the state’s share of Medicaid payments through taxing districts, was found in September to deliver a profit to some hospitals.
The reinstated payments—retroactive to when CMS halted the funding last fall—provide much-needed relief to hospitals by reimbursing them for the Medicaid patients they serve. However, CMS continues to audit the LPFF and it remains to be seen whether it finds the funding program to be in violation of the state’s Medicaid 1115 waiver.
3. What They’re Watching: Stephanie Rogers, Aetna Better Health of Texas
Stephanie Rogers, CEO of Aetna Better Health of Texas, is focused on implementing creative new funding models to improve the performance of Texas’s health care system. One example of this, she said, is her organization’s considerable investment in home and community based services (HCBS). This investment allows HCBS staff to be a “frontline monitoring system” that can tell the Medicaid plan important information about its members.
Aetna Better Health of Texas also has a program that pays for its enrollees to become community health workers. She emphasized the importance of this workforce in the care delivery process. “Community health workers are really helpful in not only creating that continuity and making sure that what we anticipated happening is really what’s happening every day, but also just being out in the community and helping individuals access care …” Rogers said.
4. The courts and Texas health policy
Last month saw some noteworthy movement in the judicial health policy space in two court battles that have implications for Texas. On March 18th, pro-choice advocacy organizations the Texas Equal Access Fund and the Lilith Fund for Reproductive Equity filed two separate lawsuits in federal court against the pro-life America First Legal Foundation and the Thomas Moore Society. These lawsuits come after the latter two groups filed a petition in state court to depose leaders of the former group for violating SB 8 by continuing to support the provision of abortions.
In the most recent development in the litigation over Gov. Abbott’s order to report families of children who receive gender-affirming care, the 3rd District Court of Appeals issued a temporary injunction against state investigations of this activity as “child abuse.” This move prevents the Attorney General’s office from taking punitive action against such families until the case is decided. The trial is set for July 11.
5. Child health prioritized during legislative interim
State lawmakers will be particularly focused on improving children’s health during the legislative interim. Lt. Gov. Dan Patrick’s recently announced Senate interim charges include a directive for the Health and Human Services Committee to identify ways to improve the child welfare system, as well as for the Education Committee to evaluate vaping prevention efforts in schools.
House Speaker Dade Phelan, who released the House interim charges last month, has created two interim committees: the House Select Committee on Health Care Reform and the House Select Committee on Youth Health and Safety. The former, along with analyzing health care costs and identifying ways to increase coverage, will work to increase outreach for CHIP enrollment and study the impacts of deferred preventive child care. The latter committee will focus on improving children’s mental health.