Healthcare
Texas House pushes for more aggressive rainy day investing
AUSTIN — The state comptroller would have to take a bit more risk investing most of the money in the rainy day fund under a bill the House approved Thursday.
Rep. Dan Branch, R-Dallas, said his measure is about “being safe” with taxpayer dollars but also “being a better steward.”
Even if Comptroller Susan Combs continued to invest the rainy day money very conservatively, she could earn about 3 percent interest on slightly more than half of the fund balance over the next two years, Branch said. The more aggressive approach would generate about $450 million in additional earnings, he said.
The bill would require about $4.3 billion of the $8 billion currently in the rainy day fund to continue to be kept in highly liquid, low yield assets.
They are not all that different from cash, said Branch and another author of the bill, Rep. James Frank, R-Wichita Falls.
Branch invoked a parable from the Bible as he urged colleagues to put at least some of the money to better use.
“We shouldn’t be burying our treasure,” he said.
Read more here…
Interactive: Comparing State Medicaid Expansions
From: Texas Tribune
If Texas lawmakers decide to expand Medicaid, as called for in the federal Affordable Care Act, the spending, savings, enrollment growth and reduction in the number of uninsured residents are poised to be greater in Texas than in most other states. This interactive compares the expansion of Medicaid in each state using data from a report by the Kaiser Family Foundation, a nonpartisan health care think tank.
Expanding Medicaid in Texas would have the third-highest total cost — behind New York and California — at $478.3 billion from 2013 to 2022. The federal government would pick up the majority of the tab for individuals covered by the expansion. For the first three years, the federal government would pay 100 percent of the costs for expansion enrollees, and then would taper that amount until it reached 90 percent. In Texas, the federal government would pay $305.3 billion, while the state would pay $168.6 billion over this period.
Changes coming to Texas health care
From: San Francisco Chronicle
Gov. Rick Perry has promised to fight tooth and nail against implementing the Affordable Care Act. But that doesn’t mean big changes aren’t coming to Texas health care, and it won’t save lawmakers from facing tough spending decisions.
Perry has refused to expand Medicaid, the health care program for the poor. And last week he announced Texas will not set up a federally-mandated health care exchange, an online system that allows people to find affordable insurance and lets them know if they are eligible for discounts or subsidies.
Texas has about 6 million uninsured residents, which comes out to nearly a quarter of its population — higher than any other state. Both Republicans and Democrats agree that’s too many, but they disagree on how to get that number down.
Before Health Exchange Deadline, Perry Reaffirms Stance
From: Texas Tribune
Ahead of a Friday deadline to decide, Gov. Rick Perry’s office has reaffirmed that Texas will not implement a major tenet of federal health reform — a state-based online marketplace for consumers to purchase coverage.
That means the federal government will have to roll out a program for Texas instead. Every state must have an exchange by 2014, the year “Obamacare” — which many Republicans had hoped would be repealed if Mitt Romney won the presidency — requires most Americans to carry coverage.
Allison Castle, Perry’s spokeswoman, said Texas won’t design its own exchange because there is “really no such thing as a ‘state exchange.’”
“This is a federally mandated exchange that must be approved by the Obama administration, and will dictate the rules states must follow,” she said. “Texas will not be a subcontractor to Obamacare.”
Interactive: Uninsured Texans by County
From: Texas Tribune
Texas has the highest rate of uninsured residents in the nation, according to the U.S. Census Bureau. More than 26 percent of people 65 and younger — 5.8 million Texans — were uninsured in 2010. More than half of those people, 3.8 million, had an annual income less than or equal to 200 percent of the federal poverty line, which was $22,050 for a family of four in 2010.
Counties along the Texas-Mexico border have some of the highest uninsured rates. But nearly half of the uninsured population in 2010 — 2.7 million people — lived in the five most populous Texas counties, which contain Houston, Dallas, Fort Worth, San Antonio and Austin. In Harris County, the most populous county in the state, one of every three residents younger than 65 didn’t have health insurance in 2010.
This interactive map shows the percent of the population 65 and younger in each Texas county that lacked health insurance in 2010, according to the U.S. Census Bureau. Hover over a county to see the size of the population and the number of uninsured.
Texas counties consider going it alone on Medicaid expansion
Not joining Medicaid expansion will hurt hospitals, clinics and taxpayers, officials say
From: Austin Statesman
Hospitals and uninsured residents are likely to be hit the hardest if Gov. Rick Perry’s rejection of a massive expansion of Medicaid stands, leaders of health care organizations said.
In addition, clinics that care for the uninsured will be strained further, while taxpayers and patients with health insurance could pay more for health care, they said.
Perry said in a letter to the federal government Monday that the state won’t expand Medicaid as the federal health care law intended because that would “threaten even Texas with financial ruin.” He also called it a “brazen intrusion on the sovereignty of our state.”
Perry’s stance is likely to prevail with a Legislature dominated by fellow Republicans.
But uninsured people will continue to seek care at hospitals, often in emergency rooms, where care is most expensive, and in clinics that serve uninsured people and those on Medicaid, a state-federal program that covers the poor, disabled and most nursing home residents.
Rick Perry: Texas Will Not Be Implenting ObamaCare
From: Town Hall
Texas governor and former GOP presidential candidate Rick Perry sent a rejection letter to Health and Human Services Secretary Kathleen Sebelius today saying Texas will not be implementing ObamaCare in its entirety.
Texas will not expand Medicaid or establish a health insurance exchange, two major tenets of the federal health reform that the U.S. Supreme Court upheld last month, Gov. Rick Perry said in an early morning announcement.
“I stand proudly with the growing chorus of governors who reject the Obamacare power grab,” he said in a statement. “Neither a ‘state’ exchange nor the expansion of Medicaid under this program would result in better ‘patient protection’ or in more ‘affordable care.’ They would only make Texas a mere appendage of the federal government when it comes to health care.”
SCOTUS Rules Federal Health Reform Constitutional
From: Texas Tribune
The Patient Protection and Affordable Care Act, President Obama’s signature health care legislation, is constitutional — including the individual mandate that forces Americans to carry health insurance, the U.S. Supreme Court ruled Thursday.
The decision has far-reaching implications for Texas, where leaders have ardently opposed “Obamacare” even though the state has the country’s highest percent of uninsured residents. In addition to requiring all citizens to purchase health insurance, the law dramatically expands Medicaid, which already makes up close to a quarter of Texas’ state budget.
The Supreme Court ruled 5-4 to uphold the individual mandate, saying it is constitutional under the federal government’s taxing power: The only effect of not carrying insurance is paying a tax. The court also held that the Medicaid expansion is constitutional, but that the federal government may not withhold Medicaid funds from states that fail to comply with the expansion. (Read the ruling here.)
Texans Brace for Supreme Court’s Health Care Verdict
From: Texas Tribune
As the U.S. Supreme Court prepares to rule on the Affordable Care Act, Texas officials, insurers and physicians are looking at potential outcomes that could keep health care reform in the spotlight for months to come.
The verdict, which will be delivered by June 28, could uphold the law, uphold parts of it but strike down provisions like the individual mandate or completely overturn the law.
No matter which decision is made, the state will continue to be involved in health care debates, said Attorney General Greg Abbott. If the law is upheld, Abbott said, there will probably be new lawsuits — both at the state and federal levels— concerning its other components. And if the law is completely struck down, both Congress and Texas will look for other legislation to address health care reform.
“Striking down Obamacare doesn’t solve health care problems,” Abbott said.
Uncertainty as to what the court will decide leaves many struggling to determine what changes to prepare for.
@TXCR
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