In a state whose GOP leaders are still fighting to criminalize homosexuality and flirting with abolishing Medicaid, a leader with a great deal of skill, commitment, and persistence is often the only hope for even remotely progressive legislation.
Texas has such a leader in Democratic state Rep. Garnet Coleman, a DLCC Board of Directors member, who capped off a multi-year fight with two critically important legislative victories this session: a new suicide-prevention law and a law to dramatically increase access to health care in rural areas.
SB 984, the rural health care bill, solves a problem that has been vexing hospitals in rural communities for decades: how to ensure there are enough doctors. Enrique Rangel of the Lubbock Avalanche-Journal explains the solution:
With the State of Texas needing to find ways to trim billions of dollars to balance its budget, shifting pharmacy services from a fee-for-service system to a Medicaid managed care system in order to save money may seem like a good idea at first blush. A closer look at the proposed Medicaid managed care "carve-in" of pharmacy services, however, reveals that any such savings predicted from the program are elusive, manufactured, and fleeting, at best.
Currently, pharmacy services for Medicaid patients are delivered by community-based pharmacies who are reimbursed by the state through a fee for service structure. This simply means that the state reimburses a pharmacy a pre-determined rate to cover the cost of the product (drug) and the cost of doing business (paying the pharmacist). The administrative cost of this approach to the State is a mere 1% of total program outlays.
The Texas legislature is proposing that Medicaid pharmacy services be shifted to a restricted managed care system where "middlemen," known as Pharmacy Benefit Managers (PBMs), would set the rules for administering pharmacy services to Medicaid patients. It is asserted by proponents of this change that this move would save money, but such "savings" come only in the form of a premium tax on health insurance plans, which would in turn be passed on to all consumers of private insurance products in Texas.
This premium tax "benefit" to the State is nothing more than a tax and is dwarfed by the economic damage that a the resulting restriction in access to pharmacy services would impose on the State and its citizens.
Repbulcain State Senator Robert Deuell has asked Republican State Attorney General Greg Abbott if there is any way he can increase the number of unwanted pregnancies in the state of Texas and, to that end, potentially slash Texas' Women's Health Program by as much as 90% in the process.
Did I mention that the Women's Health Program prevented 10,000 unwanted pregnancies in 2008? Or that the program saves the state $40 million a year?
Does that matter to a fiscally conservative Republican like State Senator Robert Deuell? Of course not. From the Texas Tribune:
State Sen. Bob Deuell wants Planned Parenthood's clinics out of the state’s Women’s Health Program, which provides family planning services — but not abortions — to impoverished Medicaid patients. And he says a 2005 law should exclude them already.
But for years, the state’s Health and Human Services Commission has allowed those clinics to continue participating, disregarding the legislative mandatefor fear that barring them might be unconstitutional. Deuell has asked Texas Attorney General Greg Abbott to clear up the matter, hoping it will free up the agency to push Planned Parenthood out.
Do the Planned Parenthood facilities that offer services through the state's Women's Health Program offer abortion services? Of course they don't. That'd be against the law. Do Planned Parenthood facilities offer considerable more privacy for women seeking health care -- especially, in the case of this program, underprivileged women ages 18-44? Of course they do.
State health officials have a lot riding on the outcome. If they adopt and follow the rule lawmakers intended — and it doesn’t align with federal Medicaid policy — they could risk losing big bucks: $18 million of the $20 million the state spent on the Women’s Health Program in 2009 came from the federal government, according a brief HHSC sent to the attorney general.
Planned Parenthood advocates say the clinics provide stellar reproductive health care and that they’re often the only family planning outfits available in Texas communities. And by all accounts, the program — launched in 2007 as a five-year pilot for impoverished women aged 18 and 44 — is effective. With just a fraction of eligible women currently enrolled, the program prevented 10,000 unplanned pregnancies in 2008 (through contraception and other family planning methods, not abortion), and it saved the state roughly $40 million a year, according to a recent HHSC study.
Does any of this matter to Republican State Senator Robert Deuell? Of course not. Know why? Because the ideological straight-jacket that envelopes Senator Deuell, Rick Perry, and the rest of the Republican leadership forces them to reject even the most common-sense measures....even the most obvious of successful health programs...even successful health programs that save the state money.
What State Senator Robert Deuell lacks in common sense he makes up for in senseless cowardice. If you're in North Texas, or the Houston area, feel free to show Senator Deuell how much you care about him.
UPDATE: From the comments:
All of you in SD 2 can support his opponent in the race Kathleen Shaw, anyone out of the district can help too with contributions. http://www.kathleenshaw.net/
According to a new report by the Annie E. Casey Foundation, Texas ranks 34th nationally in a state-by-state study on the well-being of America's children. There are also significant areas in which Texas is among the worst in the nation, and these ranks represent a failure in many of the public policies instituted over the last two decades.
Texas is among the very worst in preventing teenage pregnancies. The teen birth rate in Texas in 2007 was 64 births per 1,000 females ages 15-19, which is considerably higher than the national rate of 43 births per 1,000. Texas ranked 48th in the nation in teenage pregnancies, and only New Mexico and Mississippi ranked higher. This follows a nationwide trend of increased teenage pregnancies. According to a report by the Guttmacher Institute, after a decade of declining teenage pregnancies the nationally teen pregnancy rate rose 3% in 2006, which reflected an increase in teen birth of 4%. The report notes that the cause of the decline in teenage pregnancies in the 1990s was due to more and better use of contraceptives among sexually active teens. However, during the 2000s sex education programs aimed exclusively at promoting abstinence, and these programs have lead to increasing teen pregnancy rates especially in states such as Texas.
Texas Republicans are going to lie, every day from now until November, about health care costs. Elise Hu with the Texas Tribune reports, "Blame it On Health Care":
As Elise reports, the health care bill will not contribute, in any way, to the $11-$15 billion budget shortfall Rick Perry and Texas' Republican lawmakers. But Republicans will still repeat the claim that the budget shortfall they created is due to the fact that Democrats believe that providing health coverage to $4.3 million more Texans is a good thing.
The Texas Attorney General is suing against "Obamacare" in order to protect "States Rights" to control health insurance companies doing business in Texas! But, maybe there's a thing called Abbottcare (or, Perrycare) that Texans should examine more closely.
Once, Abbot was in favor of mandates, now he's not. It's not just the hypocrisy "I was for it, now I'm against it." It is also the hypocrisy of the entire "States Rights" argument being used to cover up over a decade of Republican neglect of Texas health care reform by Texas' 100% statewide Republican elected officials.
On Dallas KRLD talk radio 1080 early this afternoon, I heard Dallas County Republican Chairman, Jonathan Neerman, assert that all Republicans support the end to the pre-existing conditions exclusion for health insurance.
This surprised me.
For one thing, when I called Congressman Lamar Smith's office back in November to inquire about any Republican proposal to end pre-existing conditions, I was told there was a proposal and if I would wait on hold the staff person would find it. The staff person never returned to the line. So, I concluded there was no Republican plan to end pre-existing conditions that Congressman Smith was willing to endorse.
So, when Jonathan Neerman, the Dallas County Republican Chairman, asserted as a fact that "all Republicans" are against the practice of excluding pre-existing conditions, I was just wondering how Lamar Smith missed that, and how Republicans might propose ending the practice.
I would have thought that if all Republicans support this "limited and incremental" reform, and if all Republicans believe in "States Rights", then all Republicans would have pressured the State Insurance Board to require that insurance companies doing business in Texas abandon the pre-existing conditions exclusion in policies of insurance companies under the jurisdiction of the people of Texas.
Jonathan Neerman was responding to a KRLD talk show host (Scott) about the baby (Houston Tracy) born March 15th in Crowley, Texas, who had a pre-existing heart condition. Coverage was denied by his father's health insurance as soon as the condition was known. (See, http://bit.ly/9w4b0U) Neerman claimed that Republicans were universally opposed to pre-existing condition exclusions" and would have taken care of that problem if the Democrats hadn't shut them out of the Health Care Reform debate.
In my opinion, Democrats should make this a cause celebre in Texas leading up to the election in November.
Just as Republicans sat on their hands for the 12 years they controlled Congress, Governor Perry and Atty Gen. Abbott have sat on their hands for over a decade while the State Insurance Board was allowing insurance companies to get away with denying coverage based on "pre-existing" conditions. Now, baby Houston is paying the price for the malfeasance and hypocrisy of Gov. Perry, Atty. Gen Abbott, and the entire statewide Republican leadership.
I've written here at Burnt Orange before, but because some of the personal information I have to disclose to complete this diary, I've decided that I'll forgo my usual handle. Enough people have been hurt by the actual events I'll be describing...and I hope to be able to shield those who deserve protection.
The initial action that forced my hand on this was Randy Neugebauer (Tx-19) yelling, "Baby killer!" at Bart Stupak during the debate on health care. I'm generally a tolerant person, and I understand that some very good people are on the other side of the abortion issue. But it's time those of us who are pro-choice begin to explain, in no uncertain terms, why it is so important to have access to abortion. To wax Shakespearean, there are more things on heaven and earth than are dreamt of in the conservative ideology.
As soon as President Barack Obama signs the health reform bill passed by the House last night into law, insured Texans will see immediate improvements to the insurance policies they hold, while some of the most at-risk Texans--who have the hardest time accessing insurance--will finally be able to receive the care they need.
These crucial reforms are a tremendous step forward for the American people in their ability to access quality, affordable care. These reforms are the very efforts Rick Perry and Attorney General Greg Abbot are trying to prevent the people of Texas from receiving.
Adult children may remain as dependents on their parents' policy until their 27th birthday.
Children under age 19 may not be excluded for pre-existing conditions.
No more lifetime or annual caps on coverage.
Free preventative care for all.
Adults with pre-existing conditions may buy into a national high-risk pool until the exchanges come online. While these will not be cheap, they're still better than total exclusion and get some benefit from a wider pool of insureds.
Small businesses will be entitled to a tax credit for 2009 and 2010, which could be as much as 50% of what they pay for employees' health insurance.
The "donut hole" closes for Medicare patients, making prescription medications more affordable for seniors.
Requirement that all insurers must post their balance sheets on the Internet and fully disclose administrative costs, executive compensation packages, and benefit payments.
Authorizes early funding of community health centers in all 50 states (Bernie Sanders' amendment). Community health centers provide primary, dental and vision services to people in the community, based on a sliding scale for payment according to ability to pay.
No more rescissions. Effective immediately, you can't lose your insurance because you get sick.
The Statesman has an expanded timeline of some of the larger reforms. Should Rick Perry be re-elected, these reforms would occur during the next four years of his administration. Our governor would spend the next four years trying to prevent benefits from reaching the people of Texas.
Community health centers. Young people insured until age 27. No more lifetime caps on coverage. Keeping your insurance when you need it most. These are popular, common-sense reforms that the people of Texas need. Rick Perry doesn't agree with it. It's time to elect a governor who does.
Governor Rick Perry released a statement on the landmark health insurance reform legislation that passed the House of Representatives last night. Emphasis mine:
"Unfortunately, the health care vote had more to do with expanding socialism on American soil than it does fixing our health care finance and delivery systems. The Obama health care bill undermines patient choice, personal responsibility, medical innovation and fiscal responsibility in America.
"As passed by the U.S. House, the bill will cost Texas taxpayers billions more, and drive our nation much deeper into debt. Congress's backroom deals and parliamentary maneuvers undermined the public trust and increased cynicism in our political process.
"Texas leaders will continue to do everything in our power to fight this federal excess and find ways to protect our families, taxpayers and medical providers from this gross federal overreach."
Here are the real facts:
Texas has the highest rate of uninsured residents in America, at 25%.
Texas has the highest rate of uninsured children in America, at 20%.
Under Rick Perry's misguided leadership, insurance premiums in Texas have risen 91.2%.
Rick Perry opposes this bill because it provides consumer protections for working Texans who need affordable, accessible health care.
This bill creates competition between insurance companies to offer the best care for affordable costs. It ends the terrible anti-consumer practices of denial for pre-existing conditions and rescission of insurance when folks need it most. It will lower costs, make our insurance system more efficient, and help establish access to basic medical care as a right, not a privilege for the American people.
The bill is a good bill that will go a long way to helping the millions of Americans who are insured, and millions more who are under-insured or worried about losing coverage every day. That's why the bill was endorsed by so many leading advocacy groups, including:
The American Medical Association
The American Association of Retired Persons
The AFL-CIO
The Catholic Health Association
The Consumers Union
Doctors. Retirees. Working people. Catholic hospital workers. Consumers' groups. But not Rick Perry.
Instead of celebrating this historic reform that will save the lives of thousands of Texans, Rick Perry is playing partisan politics and raising the specter of "socialism." It's just more politics as usual from Rick Perry. Texas can and must do better this November.
