March Madness in Austin

by Tom Banning 

For true college basketball fans, March can never come soon enough as it is the beginning of what is known around the world as March Madness. For those of you who do not follow college basketball or are not familiar with March Madness, it is the premier college basketball tournament where 64 teams compete to decide the men’s and women’s national championship. It is also the time of year when surprise upsets occur, overnight everyone in the country becomes an expert prognosticator on the outcome of the tournament, players step-up to lead their teams to the promised land, and anything can and does occur.

So what does college basketball have to do with Texas politics? You start with a purging of incumbent Democrat legislators by trial lawyers and Democrat partisans exacting revenge on several colleagues who crossed the party line to vote for tort reform and/or redistricting. Put into the mix an on-going and ever expanding investigation by Travis County District Attorney Ronnie Earle into possible illegal campaign finance abuses by the Texas Association of Business and Texans for a Republican Majority. Couple that with an aggressive set of health-care-related interim studies. On top of all that, add the constant threat of a special session to reform Texas’ school finance system by expanding the tax base. Voilla! You have all the makings of a Texas version March Madness. Stay tuned …

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Special session: 

Anything can happen

 

Lawmakers continue to struggle to find ways to reform Texas’ outdated public school financing system as pressure for a special session mounts. Adding to the lawmakers struggle, Texas’ school financing system is being challenged in court, a number of school districts are at or near the maximum property tax levels, and there has been an intensifying public outcry for property tax relief.

 

When the Legislature does act to reform the current system, a new tax plan will be required to finance public education and right now, everything is on the table.

 

The current public education funding system, commonly known as Robin Hood, takes money from the state’s wealthiest school districts and sends it to poorer districts to equalize funding among all schools.

 

The system was adopted to satisfy constitutional mandates of free public schools for all and spending roughly the same on each student. To create equality among districts the system annually “recaptures” about $1.1 billion from the richest school districts — about 11 percent of the districts — and redistributes it among the rest.

 

Currently, almost half of the state’s 1,100 school districts are near or at the constitutional cap of $1.50 per $100 valuation, forcing many districts to cut spending on public education. The average Texans pays $905 in school property taxes, the nations 15th highest rate.

 

With this bleak outlook in mind, a number of legislative committees began studying options for new state taxes to offset as much as $8 billion in cuts to local school property taxes. To date, no firm plan on how to reform Texas’ school finance system has taken form, but a number of options are floating around including:

  • Increasing the sales tax rate;

  • Expanding the sales tax to include services previously exempted or excluded;

  • Creating a business activity tax;

  • Authorizing video lottery terminals for use at existing horse and dog tracks;

  • Increasing cigarette and other “sin” taxes;

  • Closing the franchise tax loophole;

  • Creating a statewide property tax system by splitting the property tax rolls with business being treated differently from residential taxes.

Gov. Perry has said he will call lawmakers into special session this spring if there is consensus among legislative leaders to revamp the school finance system. As of press time, no consensus has been reached.

 

TAFP is working closely with TMA and other specialty societies to make sure that any new tax plans do not impede on access to medical care. Stay tuned …

 

Contact the TAFP Legislative Department:

 

 Tom Banning, Director of Legislative Affairs

 

On To the Promised Land

 

Lt. Gov. David Dewhurst recently charged standing committees on various health-care-related issues to work over the legislative interim. These interim studies will serve as a guide for the next legislative session. Here is a sampling of issues that will be studied and likely debated next session:

 

State Affairs Committee

  • Study the implementation of House Bill 4 and Proposition 12 in achieving lower medical malpractice rates and providing more access to affordable health care. The committee will monitor and report on trends in medical malpractice insurance rates and the effect tort reform has on access to health care and provider shortages in certain regions, particularly along the border.

  • Study the implementation of changes made to the state group health insurance plans and identify additional cost-saving measures. The committee will study the feasibility and practicality of offering health reimbursement accounts as an alternate health insurance plan for those insured in the Employees Retirement System, the Teacher Retirement System, and university plans. The committee will also provide recommendations regarding whether the current method of administering these programs is in the best interest of the state of Texas and the various insured populations, or whether such programs might be more efficiently administered in another fashion.

  • Study the implementation of SB 10 and SB 541, and make recommendations, as needed, to make health insurance more accessible and affordable for all Texans.

  • Study the April 2003 United States Supreme Court decision in Kentucky Association of Health Plans v. Miller to determine its impact on Texas laws regulating health insurance plans under the Employee Retirement Income Security Act of 1974 (ERISA) and make recommendations to change state law to conform with recent federal court decisions.

  • Study the reimbursement methodology of health care plans operating in Texas for out-of-network claims, and make recommendations on how to improve effectiveness. The study and recommendations should encompass all plans, including those participating in Texas’ Medicaid managed care program and should consider federal and state laws as well as Health and Human Services Commission rules relating to the reimbursement of out-of-network claims.

Subcommittee on Higher Education

  • Review and make recommendations relating to the adequacy of funding for state graduate medical education, including funding required for professors, facilities, research programs and students. The subcommittee will consider recommending an increase in the number of health professionals.

 
 

Health and Human Services Committee

  • Study and make recommendation on structural reform, efficiency improvements, and cost savings in the state Medicaid and CHIP programs, with the goal of changing the method and delivery of service to reduce costs while providing the intended services.

  • Monitor implementation and make recommendations to improve HB 2292, including reviews of implementation of the preferred drug list and prior authorization and the new call center for determination of program and service eligibility.

  • Study and make recommendations on improving Texas’ county and local indigent health care systems. The committee will consider whether the system should be regionalized to reflect usage and gain efficiencies, so that one or more counties are not paying for regional health care.

  • Monitor the implementation and make recommendations to enhance the effectiveness of legislation relating to the Board of Medical Examiners, legislation relating to childhood immunizations, legislation relating to the pilot front-end Medicaid fraud reduction systems, federal developments related to TANF reauthorization and related programs, expansion and construction of Federally Qualified Health Centers, federal developments related to prescription drugs in Medicare and the effect on Medicaid. Also, the committee will monitor and report on the use of new federal Medicare funds allocated for Texas.

  • Study and make recommendations on increasing electronic transactions in health care. They will review the use and make recommendations on improving technology in health care administration, including expediting pre-authorizations and increasing the efficiency of claims processing so that medical providers are paid once procedures are pre-authorized and performed, and administrative costs lowered, benefiting both the consumer and the managed care organizations.

  • Study health facility regulation in Texas and make recommendations that facilitate innovation and patient safety. The committee will study hospitals, including niche hospitals, Federally Qualified Health Centers and long term care facilities, and make recommendations for improving patient choice, facility competition, indigent health care, and for maintaining a competitive, patient-oriented health care industry.