Legislative Update, January 7th
With days to go before the start of the 86th Legislative Session, Methodist Healthcare Ministries is gearing up to review hundreds of bills impacting the health and well-being of all Texans, especially our most vulnerable citizens. In this newsletter, we'll provide regular updates on filed bills, hearings and votes taken on issues impacting the health of our families.
- Texas Has Highest Uninsured Population in the Nation
- Affordable Care Act Ruled Unconstitutional by Federal Judge
- Supplemental Nutrition Assistance Program Protected by Passage of Farm Bill
- Vaccine Policies Protect Day Care Centers
- House Committee Studies Public Health Issues
A new report recently released by the Episcopal Health Foundation and Urban Institute estimates that 19 percent, or 4.7 million, of Texas’ nonelderly population remained uninsured in 2018 – the highest uninsured rate of any state in the country. Texas is a state with significant challenges in reducing the number of uninsured because of its size, racial and ethnic diversity and large number of noncitizen residents. Two-thirds of uninsured Texans live in working families and more than half are in families that include at least one full-time worker. About 60 percent of uninsured Texans include low-income families of four, earning less than $35,000 a year.
With the highest percentage of uninsured residents in the country, Texas needs to make substantial strides in increasing coverage and improving affordable care. Without statewide policy changes, the number and share of uninsured Texans will likely increase with time as health care costs continue to rise, making coverage less affordable for low- and middle-income families. Developing a state plan that could offer health insurance to low-income adults with incomes up to 138 percent of the Federal Poverty Level (FPL), would provide an estimated 1.3 million uninsured Texans with access to free or very low-cost coverage.
As part of its 86th Legislative Agenda, Methodist Healthcare Ministries will be actively involved with statewide healthcare organizations in crafting an alternative coverage proposal that could garner leadership support and sustain federal waiver funding currently set to expire in the near future.
A federal judge in Texas has ruled that the Affordable Care Act’s (ACA) individual coverage mandate is unconstitutional and that the rest of the law, therefore, cannot stand. U.S. District Court Judge Reed O’Connor believes the entire ACA cannot stand without its individual mandate penalty, which Congress zeroed out last year. However, the ACA will remain as current law while the judgment is appealed.
The invalidation of the ACA questions the future of health coverage for 20 million Americans in the marketplace exchange and in states that expanded Medicaid. The health care law has allowed young adults to stay on their parent’s plan until the age of 26, guaranteed access to coverage for people with preexisting conditions, made coverage more affordable and expanded coverage of Medicaid in 37 states. Should the law be found unconstitutional after the appeal, those 20 million people buying health insurance in the exchange would see these protections go away. Another group at risk will be individuals with pre-existing conditions. Without the protections from the ACA, insurers could return to denying coverage or charging more. The Kaiser Family Foundation estimates that 52 million adults from ages 18 to 64 would be rejected for coverage under the practices that were in effect in most states before the Affordable Care Act.
From here, the case will likely move to the Court of Appeals and up the Supreme Court. In the meantime, consumers can still expect that the ACA’s protections and regulations will continue to apply in every state. Methodist Healthcare Ministries will continue to advocate at the state and federal level for policies that increase access to health care for our state’s neediest families.
After months of heated debate, the U.S. House and Senate have passed a bipartisan farm bill that protects food security programs such as the Supplemental Nutrition Assistance Program (SNAP). SNAP has been the nation’s most effective anti-hunger program and the new farm bill reauthorizes SNAP and provides for modest improvements to program integrity and administration. A report by the American Heart Association shared that the bill rejects proposed cuts and other harmful changes to SNAP that would have caused more than 7 million people to lose their benefits altogether or face reductions.
While the bill does not address issues of SNAP households running low or out of food at the end of each month, it is a great building block for future farm bills and policies to improve diet quality. The final bipartisan bill continues to protect SNAP and makes fresh fruits and vegetables more accessible and affordable, providing opportunities for families to eat healthier.
At the state level, Methodist Healthcare Ministries will be supporting efforts to strengthen the impact of the SNAP program this legislative session by looking for ways that families can be rewarded for making healthy food choices with their current program allowances.
A leading anti-vaccine group has made recent claims that daycares are breaking the law by denying kids who have not been vaccinated, but experts are saying that the group is misinterpreting the law. Texans for Vaccine Choice, a group focused on anti-vaccine policy, reports receiving hundreds of calls and emails from parents who were rejected by private child care facilities due to lack of vaccinations. Texas law mandates vaccine requirements for licensed child care centers, including cases around medical and conscience exemptions. Texans for Vaccine Choice has argued that facilities do not have the right to deny exemptions for vaccinations, but experts note that current law does not require daycare centers to enroll everyone, regardless of immunization status. Allison Winnike, president and CEO of The Immunization Partnership, states that private daycare centers are allowed to have additional admission requirements beyond the minimum set by state law, which may include requiring that every child enrolled be vaccinated. An increasing number of child care centers have additional vaccination requirements to encourage enrollment of medically fragile children. Methodist Healthcare Ministries is a strong advocate for policies that promote vaccinations and protect medically fragile children from being exposed to preventable diseases. These efforts are a part of MHM’s 86th Legislative Session initiatives and legislation will be closely monitored to ensure all children remain protected.
The Texas House Committee on Public Health has a significant interest in the health of Texans and has held a number of hearings this past year addressing some of the health care challenges impacting Texas communities. According to their Interim Report to the 86th Texas Legislature, the committee studied a range of topics that encompassed women’s health, mental illness, housing instability, healthcare delivery in underserved areas, CPS involvement due to substance use or mental illness, and implementation of key health bills passed during the 85th Legislative Session.
Relating to women’s health, the Public Health Committee recommended establishing auto-enrollment for eligible women aging out of the children’s Medicaid and CHIP programs into the Healthy Texas Women’s program. They also provided recommendations for children’s mental health, such as increasing the learning opportunities regarding mental health for teachers and administrators and creating a subcommittee of the Texas Health and Human Services Commission to review and oversee coordination of all state and federal funding addressing mental and behavioral health of school-age children. Committee members also recommended further exploration in the benefits of expanding permanent supportive housing for more than 25,000 homeless individuals in Texas.
Methodist Healthcare Ministries closely monitored the House Committee on Public Health throughout the interim and strongly supports a number of recommendations, including auto-enrollment into the Healthy Texas Women program and increasing funding for mental health services across the continuum.
Jan 8: 86th Texas Legislature Convenes at 12:00 Noon (Austin)
Jan 10: Texas Tribune: A Conversation with Comptroller Glenn Hegar (Austin)
Jan 18: Texas Tribune: A Conversation with State Rep. Dennis Bonnen (Lake Jackson)
Feb 6: 2019 Texas Mental Health Capitol Day Rally and Advocacy Training (Austin)