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John Zerwas

Zerwas out, Bonnen in for Speaker

A harbinger of intrigue.

Rep. John Zerwas

State Rep. John Zerwas, a Richmond Republican, has withdrawn from the race for speaker of the Texas House, he confirmed to The Texas Tribune on Sunday evening.

“I am grateful for the opportunities I have had to engage with the members of the House. The honest conversations are critical to the relationships I have, and I am honored to work with such principled leaders,” he said in a statement to the Tribune. “While I believe that I could lead the House through a successful 2019 session, it has come time for me to end my bid for Speaker and wholly focus on writing the budget for the 2020-2021 biennium.”

His departure comes amid an effort among roughly 40 GOP House members to draft state Rep. Dennis Bonnen, R-Angleton, into the race. Bonnen did not immediately respond to a request for comment from The Texas Tribune.

On Sunday night, that group of 40 members was scheduled to gather in Austin to discuss recruiting him for the job. Bonnen previously had told The Texas Tribune in May that he was not interested in running for the top slot in the lower chamber. The Tribune was told Sunday night that Bonnen was not at the meeting.

There are still a lot of Speaker wannabes. Zerwas was the first among them, declaring his intent to run right after Joe Straus announced his departure. My speculation when I read this was that the various Straus-like candidates have concluded their best move is to consolidate behind one candidate that they think can win, someone who Democrats and enough Republicans can support, so as to pre-empt the non-Straus contenders. For that to happen, to assuage egos and whatnot, the compromise/consensus candidate would have to be someone who is not currently a candidate. And thus it was:

State Rep. Dennis Bonnen, R-Angleton, said Tuesday he is officially running for speaker of the Texas House — two days after an Oct. 28 meeting in Austin, where roughly 40 GOP House members gathered to discuss recruiting him for the job.

“Throughout my career in the House, I have always emphasized my respect for the institution as a whole as well as the unique position each member has to serve their district,” Bonnen said in a statement. “I look forward to the many conversations to come with members across the state. My desire, which I believe I share with the vast majority of my colleagues, is that this process come to a conclusion with a House ready to do the people’s business with strength, resolve, and unity in the 86th Legislative Session.”

Clearly, they were sufficiently persuasive. Not to put too fine a point on it, but this is more or less how Straus emerged as a contender for Speaker in the first place – the dozen or so renegade Republicans who were publicly gunning for Tom Craddick emerged from a meeting with him as their exemplar, and after that it was all a matter of counting noses. We’ll see if it works.

Four makes seven

Rep. Four Price files for Speaker, making him the sixth Republican and seventh member to do so.

Rep. Four Price

State Rep. Four Price, R-Amarillo, filed Thursday for speaker of the Texas House, making him the sixth Republican to enter an already crowded race to replace the retiring House Speaker Joe Straus, R-San Antonio.

“Having successfully worked for the last four sessions with my colleagues from across our state to pass major legislation and focus on issues of importance to all Texans, I am eager to seek this leadership position in the Texas House of Representatives,” he said in a statement. “Looking towards the future, I truly believe the Texas House will play a leading role in making the decisions that keep Texas on the path to prosperity.”

Price enters a speaker’s race that already includes Republicans Tan Parker of Flower Mound, Phil King of Weatherford, John Zerwas of Richmond, Travis Clardy of Nacogdoches and Drew Darby of San Angelo, as well as Democrat Eric Johnson of Dallas.

As with the other Republicans, I have no official opinion on Rep. Price, though I will note that he was endorsed by the Texas Parent PAC when he first ran for office. Honestly, at this point I’d rather see another villain type declare for Speaker, as that would help divide the bad-guy vote some more. The goal here is for the next Speaker to need Democratic help to get there, so the more division on that side, the better.

And then there were six

Five Republicans for Speaker, six in total.

Rep. Drew Darby

State Rep. Drew Darby, R-San Angelo, filed on Friday to run for speaker of the Texas House.

“After prayerful consideration, discussions with my family, and at the urging of my House colleagues, today I filed paperwork with the Texas Ethics Commission to start a speaker campaign for the 86th Legislative Session,” Darby said in an emailed statement. “In the coming weeks, I plan to visit with every House member to discuss the priorities of their district and how the Texas House of Representatives can work together to put forward good policies to keep Texas the number one state to live, work and raise a family.” 
 


Darby, who’s been in the House since 2007, joins four other Republicans in vying for the top slot in the lower chamber: state Reps. Tan Parker of Flower Mound, Phil King of Weatherford, Travis Clardy of Nacogdoches and John Zerwas of Richmond. Dallas Democrat Eric Johnson has also declared he is running.

[…]

When the Texas House convenes for its legislative session in January, picking the next House speaker will be one of its first acts. Ahead of the vote from the full chamber, House Republicans last year agreed to hold a non-binding vote to pick a speaker candidate within the GOP caucus. And ahead of this year’s primaries, the Republican Party of Texas urged candidates and incumbents running for House seats to sign a form pledging to back whoever the caucus picks as their speaker candidate. Parker and King have signed the form, while Darby, Clardy and Zerwas have not.

See here for some background. What I said about Rep. Clardy’s candidacy holds true for Rep. Darby’s. Not sure how some of these guys will distinguish themselves from their rivals, but that’s their problem.

One more for Speaker

And then there were five.

Rep. Travis Clardy

State Rep. Travis Clardy, R-Nacogdoches, filed Monday morning to run for speaker of the Texas House, making him the fourth Republican to throw his hat in the ring in the race to succeed retiring House Speaker Joe Straus, R-San Antonio.

“We’re coming out of the summer and I think it’s time we get serious about the political process,” Clardy told The Texas Tribune. “I think it’s more important than ever that we make a decision as a House to pick our leadership, and be prepared to start the 86th Legislature with a strong, positive step and a vision for the future.”

[…]

He enters a speaker’s race that already includes Democrat Eric Johnson of Dallas and three Republicans: Tan Parker of Flower Mound, Phil King of Weatherford and John Zerwas of Richmond.

Ahead of the next regular session, House Republicans agreed to select a speaker in their caucus and then vote as a bloc on the floor. Prior to the March 6 primaries, House Republicans pushed incumbents and candidates to sign a form promising to ultimately support the caucus pick. While Parker and King have signed the form, Zerwas and Clardy have not. Clardy told the Tribune Monday, however, that he does intend to vote with his party next session on who should succeed Straus.

“I’m a lifelong Republican and I was at the convention, but that pledge was originally prepared before we did the caucus vote. It’s kind of redundant,” Clardy told the Tribune. “I already voted with the caucus to support a Republican nominee out of our caucus to be the next speaker. It’s kind of backwards to pledge to do something I’ve already done.”

See here and here for some background. I don’t have an opinion on Rep. Clardy, who told his hometown newspaper shortly after Straus announced his retirement that he’d be interested in the Speaker gig. As I said in that first link above, the question is whether Republicans can coalesce around a single candidate so that they can elect him (all the candidates so far are male) without needing any dirty Democratic support, or if their divisions are too deep and whoever comes crawling to the Dems first wins the prize. The more Dems there are, the fewer Republicans there are, the less room the Republicans have for dissent, the more likely that latter scenario. So basically, as with most of my other entries the past few months, the message is to get out and vote, and make sure everyone you know votes. It’s not just about Congress, after all.

Rep. Eric Johnson declares for Speaker

It’s not as crazy as it sounds.

Rep. Eric Johnson

State Rep. Eric Johnson, D-Dallas, filed Wednesday to run for speaker of the Texas House, making him the first Democrat to enter the race to succeed retiring House Speaker Joe Straus, R-San Antonio.

In a statement sent to The Texas Tribune, Johnson pointed out that, if elected, he would be the first speaker under the age of 45 since former House Speaker Price Daniel Jr. in 1973 and the first person of color to ever serve as speaker of the Texas House.

Johnson enters a speaker’s race that already includes three Republicans: Tan Parker of Flower Mound, Phil King of Weatherford and John Zerwas of Richmond.

“I’m in it, and I’m in it to win it,” Johnson told the Tribune.

[…]

“I am deeply troubled by the far rightward shift in our state government and the excessive partisanship and the poor legislation this shift has spawned,” Johnson said in a separate statement. “Texas has become a one-party state, and this has been to Texas’s detriment.”

As a Democrat, Johnson would need bipartisan support to be elected speaker in the Republican-dominated House. Ahead of the next regular session, House Republicans agreed to select a speaker in their caucus and then vote as a bloc on the floor — a move that could completely cut out Democrats from picking the chamber’s next leader. Prior to the March 6 primaries, House Republicans pushed incumbents and candidates to sign a form promising to ultimately support the caucus pick. While Parker and King have signed the form, Zerwas has not.

Let’s state up front that Republican members are not going to vote for a Democrat for Speaker, at least not as long as they have a majority in the House. Let’s also state that it is…unlikely…that the Republicans will lose the majority in the Texas House. So, barring something very unexpected, Rep. Eric Johnson will not be the next Speaer of the House.

What could happen is that Republicans fail to coalesce behind a single one of their Speaker candidates, so that none of them can get a majority to become Speaker. In that case, Eric Johnson and his Democratic supporters can make a deal with one of them to push him over the top in return for some concessions. This is a more likely scenario with Democrats numbering in the mid-to-upper sixties (or higher, of course), but it could still happen with something more like the current caucus size. This is not unlike how Joe Straus became Speaker himself in 2009; I trust you will find the irony of that if it happens to be as delicious as I will. Having Johnson file as Speaker should mean that the Dems will be unified behind him, rather than making their own individual deals a la Tom Craddick in 2003.

And that’s the key. Being able to elect a Democratic Speaker would be awesome, of course, but the way the House map is drawn they’d need not just to win the statewide vote, they’d need to win it with some room to spare. That just isn’t going to happen. But being in a position to get a seat at the table, that’s a fine consolation prize. The more seats we do win in November, the closer we can get to that.

Speaker Straus not running for re-election

A bombshell no one saw coming.

Rep. Joe Straus

Texas House Speaker Joe Straus, a San Antonio Republican, announced Wednesday he will not run for re-election in 2018, a decision that has the potential to upend the political balance of power in the state.

Straus, who has lately been the most powerful moderate Republican in the Texas Capitol, said he will serve until the end of his term. That means there will be a new speaker when the Legislature next convenes in 2019.

His decision will immediately set in motion a scrum for control of the House, pitting arch-conservative members who have opposed Straus against more centrist Republicans. Within hours, one of Straus’ top lieutenants, Rep. John Zerwas, R-Richmond, announced that he had filed to run for the speaker’s post. State Rep. Phil King, R-Weatherford, has already announced he is running. Other candidates are expected to jump in.

Straus has clashed with hardline conservatives in recent years, not least Republican Lt. Gov. Dan Patrick. Tea Party leaders and their allies have blamed Straus for killing controversial measures backed by the far right, most notably a bill that would have regulated which bathrooms transgender Texans could use.

“I believe that in a representative democracy, those who serve in public office should do so for a time, not for a lifetime. And so I want you to know that my family and I have decided that I will not run for re-election next year,” Straus said in a campaign email. “My time as a State Representative and as Speaker will end at the conclusion of my current term.”

[…]

Asked if he planned to run for any other office in the future, Straus said he is “not one to close doors.” He acknowledged he has received encouragement to run for other offices and did not rule out the possibility of a gubernatorial bid. But he said he doubts he will be on the ballot in 2018.

As for the race to succeed him as speaker, Straus suggested he would not get involved.

“I don’t think it’s appropriate for people who aren’t members in the Legislature in the next session to really register an opinion on that,” Straus said.

The announcement immediately set into motion speculation about the future of Straus’ top lieutenants. One of his closest allies, Rep. Byron Cook, R-Corsicana, who is chairman of the House State Affairs Committee, said in a statement first reported by Quorum Report that he “will pursue other opportunities to serve our great state.”

Straus made his announcement on Facebook, which if you have a feed like mine immediately took over everything. This came as a big surprise, because just last month Straus was urging business leaders to keep up the fight against bathroom bills and other such harmful proposals, and two weeks ago he formed the House Select Committee on Economic Competitiveness to push pro-growth policies. I doubt it had occurred to anyone that he himself might walk away at this time, but if a young, scandal-free first-term US Senator can say “screw it, I’ve had enough”, then nothing like this should surprise us. Indeed, as Ross Ramsey notes, this will almost surely presage a lot more retirements. Get ready for it.

As to what happens next, I’m not going to panic or despair, at least not yet. For one thing, like Christopher Hooks, I’m a little wary of the hagiography coming from my fellow travelers over Straus’ legislative career.

Liberals have never quite figured out what to make of the man. On one hand, it’s undoubtedly true that Straus was a bulwark against the new populist tendencies of the Texas GOP. He and allies such as Byron Cook, who is also retiring, stopped a metric ton of junk legislation that would have passed with a different speaker. When considering the question of why Texas has fared generally better than similarly red states like Louisiana and Kansas, which are on fire, Straus and the conditions that created Straus are a significant part of the answer. He’s the last person in state government who seems to care about governing as a concept.

But out of that fact emerged too a picture of Straus as a sort of Aaron Sorkin character, a paternal figure with an unnaturally rosy image and a passing resemblance to Gregg Popovich, typified by the mythic representation of Straus’ bathroom bill showdown with Patrick in a recent New Yorker article. There is an element of Stockholm Syndrome in that, as if Straus was the jailer who always asks about your kids. Among other things, the House of Straus passed many of its own pieces of junk legislation — voter ID, loads of anti-abortion laws, etc. — and served at times as a trough for the lobby. Straus and his lieutenants often declined to water down bad legislation, including, spectacularly the state’s “show your papers” law. The Capitol debate over what Straus personally wants, and when his hand is being “forced,” is as long and storied as it is useless to ordinary Texans.

Straus isn’t Jeff Flake or Bob Corker — he’s been staying true to some version of his principles since he was elected speaker, not just recently. But it’s also worth wondering why a person who places so much emphasis on good government is willing to abandon his post, possibly to another Republican in the mold of Dan Patrick or Donald Trump. A tremendous amount now depends on whether a Straus-type successor can be elected speaker.

For sure, we could have done much worse than Straus – we had already done much worse, under Tom Craddick – and we could do much worse going forward. I’m just suggesting that we maintain a bit of perspective here. Going forward, a Speaker Zerwas would be more or less the same as Speaker Straus was, while a Speaker King would basically be Speaker Craddick minus the Craddick Dems. The way to enhance the odds of the former is for more Democrats to win legislative races next year, especially against wingnuts in swing districts like Matt Rinaldi. Perhaps the Texas Association of Business, who helped give us Speaker Craddick in 2002, might get involved in a few Republican primaries if they’d like to see Straus’ legacy live on. There are concrete things that can be done to ensure a better outcome, is what I’m saying. That’s where I’d put my energy if this news is distressing to me. The Chron, RG Ratcliffe, the Current, and the DMN have more.

What the Harvey needs are from the state

It’s not just about recovery. The long term needs, including mitigation against future events like Harvey, is where the real money will need to be spent.

More than one month after Harvey’s deluge hit, local officials, including Mayor Sylvester Turner and Harris County Judge Ed Emmett, testified at a state House of Representatives Appropriations Committee hearing that more than $370 million worth of debris removal and repair work on more than 50 government buildings has strained local coffers, necessitating quick aid and reimbursement from the federal or state government.

They also emphasized what likely will greatly exceed the costs of immediate recovery: how to prepare for the next storm. That could include billions of dollars for large-scale buyouts, a third reservoir on Houston’s west side, a reservoir on the Brazos River in Fort Bend County and hundreds of millions of dollars to jump start bayou improvement projects that have slowed in recent years without federal funding.

“There’s going to come a time where we have taken all the money from the feds, we have gotten all the money we’re going to get from the state, and we’re going to have to decide: What kind of community do we want to be?” Emmett said at the hearing.

Harvey’s record-smashing rainfall and floods damaged more than 136,000 homes and other buildings in Harris County and killed nearly 80 people across the state.

The Texas House Appropriations Committee and Urban Affairs Committee met at the University of Houston on Monday to understand public costs and where reimbursements from the Federal Emergency Management Agency, U.S. Army Corps of Engineers and other U.S. Congressional appropriations were being directed in the storm’s wake.

Emmett, Turner and Fort Bend County officials testified, as did Texas A&M University Chancellor John Sharp, who is coordinating the state’s recovery efforts. The heads of several other state agencies also testified.

The hearing came just three days after Gov. Greg Abbott visited Houston and presented Turner with a check for $50 million. The check almost immediately was spoken for, Turner said, mostly for debris removal and insurance costs.

Appropriations Chairman John Zerwas, R-Houston, said Harvey, in theory, qualified as the “perfect reason” to use the state’s so-called “Rainy Day Fund,” a savings account comprised of billions in excess oil and gas taxes.

Abbott had indicated as much last week but said he would tap existing state emergency funds and reimburse them from the Rainy Day Fund when the Legislature next meets in 2019.

“Before the Legislature acts, we need to ensure what the expenses are that the state is responsible for,” Zerwas said.

Yes, that would be nice to know. There were other hearings this week as well.

The first order of business, Harris County Judge Ed Emmett told the House Natural Resources Committee, needs to be a flood control plan for the entire state — and the Gulf Coast in particular.

The Texas Water Development Board is already in the process of crafting a statewide flood plan, with the help of $600,000 state lawmakers gave them earlier this year. Lawmakers haven’t yet promised to back any of the projects that end up in the plan.

Emmett, a Republican and former state lawmaker, said Harris County intends to put together its own flood control plan in the meantime, add up the costs of its recommended projects, then see how much the federal and state government want to contribute. He said he’ll be the first to push for a local bond package to make up the difference.

Property taxes are “the most miserable tax created,” Emmett said. “But it’s what we’ve been given to work with so we don’t have a choice.”

Emmett said Harris County’s plan likely will include another major dam to catch runoff during storms and relieve pressure on two existing reservoirs, Addicks and Barker. Those reservoirs, which filled to historic levels during Harvey, flooded thousands of homes that may not have been inundated with additional protections.

Emmett and the city of Houston’s “flood czar,” Stephen Costello, suggested the state tap its savings account, known as the Rainy Day Fund, to pay for such a project, estimated to cost at least $300 million. (Gov. Greg Abbott has said lawmakers can tap that fund in 2019 or sooner if they need it for Harvey relief; so far, he has written Houston a $50 million out of a state disaster relief fund.)

Costello said Texas should also consider creating a multi-billion dollar fund to support flood control projects similar to one the state’s voters approved in 2013 for water supply projects.

So far all of the talk is constructive, and even Dan Patrick is doing his part. The real test will be whether we follow up on any of this when the Lege reconvenes. Also, while this doesn’t directly answer my question about the SWIFT fund, but it does clearly suggest that it’s not intended for this kind of infrastructure. Which makes sense, given when it was created, but I had wondered if there was some flexibility built in. I would hope there would be plenty of support for a similar fund for flood mitigation.

Budget deal reached

The one bill that must get passed is on its way.

After months of private squabbling and public threats of a legislative overtime session, the Texas House and Senate finally compromised to unveil a joint budget late Saturday.

Lawmakers, scrounging for cash in a tight-fisted legislative session, agreed to dip into the state’s savings account and to make use of an accounting trick using funds set aside last session for highway projects.

“We have reached a consensus on what I believe is a responsible, compassionate and smart budget for the people of Texas,” said state Sen. Jane Nelson, R-Flower Mound and the upper chamber’s top budget writer, at a committee hearing that lasted late into Saturday night.

“This has been a laborious process, I have to say,” said state Rep. John Zerwas, a Republican from Richmond and Nelson’s counterpart on the House Appropriations Committee. He called the budget “fiscally conservative” during “a time when it’s a little bit more lean.”

Budget documents indicated around $1 billion would come from the state’s Rainy Day Fund, a $10 billion savings account available to shore up the budget in difficult years. That money would pay for priorities such as repairs to the state’s aging mental health hospitals and bulletproof vests for police officers.

Nearly $2 billion more would come from an accounting trick related to transportation funding approved in 2015. The proposed budget would delay a payment to the state highway fund in order to free up that funding for other needs in the current two-year budget. The House had previously been critical of the possibility.

Though lawmakers were creative in tapping alternative money sources to avoid steep cuts this budget cycle, some high-dollar expenditures, notably Medicaid, the federal-state health insurance program for the poor and disabled, were not fully funded. That means lawmakers will almost certainly need to address those underfunded parts of the budget in 2019 — their next legislative session — in the form of a supplemental budget.

The House had originally intended to use $1.4 billion from the Rainy Day Fund, then considered upping it to $2.4 billion, while the Senate aimed for $2.5 billion in pay-delay gimmickry. Nice to see everyone can give a little to get a little, I guess. No budget is ever going to be good under our current political circumstances, but this one could have been worse, and that’s about all you can hope for.

In other business from Saturday:

On property taxes, the lower chamber unanimously approved an amendment that contained key language from Senate Bill 2 — which, among other things, requires local governments to give constituents more information about proposed property tax increases — and attached it to Senate Bill 669.

The House sponsor of the bill, state Rep. Dennis Bonnen, R-Angleton, had been trying to move the legislation for weeks, and it wasn’t scheduled to come to the House floor until early next week.

The Senate bill is an item Lt. Gov. Dan Patrick has deemed must-pass legislation — he threatened on Wednesday to ask Gov. Greg Abbott to call lawmakers back for a special session if that and other measures didn’t pass. Whether Bonnen’s amendment is enough for Patrick and the more conservative Senate is still unclear: Bonnen’s amendment lacked a key provision that would require voter approval for some tax rate increases, something Patrick stated repeatedly he wanted included.

[…]

An amendment by state Rep. Four Price, R-Amarillo, would extend the lives of several state agencies that were scheduled to “sunset” – or expire. A separate measure that dealt with that specific issue didn’t survive last week’s deadline for the House to pass bills on second reading.

But Price added his language to Senate Bill 80, a measure that seeks to streamline reporting requirements for state agencies. The Senate must now concur with the changes to SB 80 in order for Price’s amendment to survive.

“The goal of the amendment originally as contemplated would not have had to extend these agencies, but for the fact they were caught up in that last night on the calendar,” he said. “It goes hand in hand [so] yes, it had the effect of extending the agencies to 2021.”

SB2 was one item on Dan Patrick’s hostage list, while the sunset bill was his leverage for it. Late last night there was a limited bathroom amendment attached to a Senate bill (I’ll have more on this tomorrow), and SB2 isn’t as Patrick wanted it, so we can’t say as yet whether his tantrum has been mollified. I’m sure he will let us know soon enough.

Making vaccination information public

I support this.

While most parents in Texas vaccinate their children, the number of parents opting out of immunizations for non-medical reasons is on the rise. Since Texas changed its laws to allow parents to opt out citing a conscientious objection, the number of unvaccinated children has shot up more than 1,700 percent in 13 years, to 45,000 from 2,300. In response, parents and health advocates are backing an effort to increase public reporting on how many students who have skipped vaccines attend each school.

Currently, that data is housed at the state level and available via an open-records request. County and school district-level data also is available online.

House Bill 2249 would require the Texas Department of State Health Services to publish school-by-school data that would indicate the total number of students who forgo vaccinations, including those who opt out by choice, such as a religious objection. No names or identifying information would be listed.

Advocates for publishing the data say the information would offer parents insight into their child’s school and help them weigh whether to switch, particularly for parents of medically fragile children like Riki Graves’ daughter, Juliana. Now 3, she received a new heart at 18 days old, and doctors say she will need to attend a school where least 95 percent of the students are immunized.

“My job as a transplant mom is to protect that organ,” said Graves as she drove from her home in Sugar Land to Austin where she plans to testify before the House Public Health Committee on Tuesday. “We have the data … there’s no reason not to publish it.”

Opponents say there are plenty of reasons, including children’s medical privacy.

“If this is truly about keeping children safe, we have to have that honest conversation about keeping all people safe. It puts a target on the backs of children whose parents have chosen to opt out for various different reasons,” said Jackie Schlegel, a mother of three and executive director of Texans for Vaccine Choice, a grass-roots parent group that has ballooned in recent years as the movement against vaccinating children has gained traction. The group is planning a rally at the Capitol on Thursday, dubbed the “freedom fight.”

“At schools where you do have a high number of opt-out, we are creating a witch hunt against families, and that’s just unacceptable,” Schlegel said.

We clearly have a different definition of “unacceptable”. I think knowing that a given school has a high rate of unvaccinated children is something any parent would want to know. HB 2249 has four co-authors, two of whom )JD Sheffield and John Zerwas) are medical doctors, which ought to tell you something. As the story notes, an identical bill passed the House in 2015 but never got a hearing in the Senate. Let’s hope this year’s version meets a better fate. The Trib has more.

House passes its budget

Mostly shenanigan-free, with a nice little side order of shade for a few people who deserve it.

After 15 and a half hours of debate on hundreds of amendments to the Texas House budget, lawmakers in the lower chamber passed the two-year, $218 billion document, with 131 votes in favor and 16 votes against.

The House vote included using $2.5 billion from the state’s savings account, colloquially known as the Rainy Day Fund. State Rep. John Zerwas, R-Richmond, thanked lawmakers for exhibiting “true leadership” with their willingness to tap the fund, “instead of electing to use an unconstitutional transfer from the transportation funding.”

That was a jab at the Senate, which last week approved its version of the two-year budget using a $2.5 billion accounting trick to free up funds dedicated to highway spending. The House must now work with the Senate, which is under the leadership of Lt. Gov. Dan Patrick, who vehemently opposes using the Rainy Day Fund, to reconcile their budget differences.

House lawmakers, debating the budget late into Thursday night, took several jabs at Patrick and other statewide elected officials throughout the evening.

Included in the fray were Gov. Greg Abbott, who saw one of his prized economic development programs defunded; Patrick, who heard a resounding “no” when his favored proposal to subsidize private school tuition with public funds was put to a vote; and Attorney General Ken Paxton, who lost more than $20 million from his agency’s budget for lawsuits.

On the winning side of the House budget debate were child welfare advocates, who saw funding for foster care and Child Protective Services tentatively boosted; social conservatives, who scored $20 million for the Alternatives to Abortion program; and the lieutenants of House Speaker Joe Straus’ leadership team who, in a display of unity, easily brushed aside most challenges from far-right Republicans.

Statewide GOP leaders took some of the heftiest blows in the House chamber. Lawmakers there voted to strip $43 million from the governor’s Texas Enterprise Fund, the “deal-closing” fund the state uses to lure businesses from elsewhere, and divide it into two equal pots: one for Child Protective Services and foster care funding, the other for a program that pays for disabled children’s physical, occupational and speech therapy services. Both are hot-button issues that have dominated the House’s budget negotiations during this legislative session.

[…]

Private school subsidies, a pet issue of Patrick and his Senate, also suffered a perhaps fatal wound on Thursday. House lawmakers voted 103-44 to prevent state money from being spent to subsidize private school tuition in the form of vouchers, education savings accounts or tuition scholarships. The proposal’s author, state Rep. Abel Herrero, D-Robstown, said it was “in support of our public schools and our neighborhood schools.”

[…]

Paxton’s attorney general’s office also saw funding gutted by House lawmakers who opted to instead fund programs that serve vulnerable children. Foster care funding would receive $21.5 million that was previously intended to pay for Paxton’s legal services budget under a proposal by state Rep. Ina Minjarez, D-San Antonio, that passed 82 to 61.

See here for more on the Enterprise Fund de-funding, which made me smile. Despite promises of shenanigans and roughly a gazillion amendments filed, there was more good done to the budget than bad. Which is not to say it’s a good budget, but it’s far from the worst we’ve ever seen. Take your positives where you can.

Especially when they involve Dan Patrick getting pwned.

In late March, lobbying group Texans for Education Opportunity used an online campaign to generate thousands of letters to 29 state representatives lobbying them to back education savings accounts, one of the subsidy programs in SB 3. Though the group claimed the letters were credible, the letters stirred up suspicion after no representative could find a constituent who remembered adding their name to that correspondence.

Of the 29 representatives targeted in the campaign, 26 voted Thursday to block money from funding “private school choice” programs.

RG Ratcliffe called it a “mugging”. As former Houston Rockets radio announcer Gene Peterson used to say, how sweet it is. Also, too, going back to the first story, there’s this:

Stickland had filed an amendment defund a state program for the abatement of feral hogs, which he’s become known for championing at the Legislature each session. Stickland railed predictably against the program, calling it “ridiculous” and a waste of money.

“It has not worked, and it never will work,” Stickland said, his voice rising.

That apparently offended rural lawmakers, notably state Rep. Drew Springer, R-Muenster. In response, Springer attached an amendment to Stickland’s proposal that would cut the same amount of funding for the Texas Department of Transportation, but only for roads and highways in Stickland’s hometown of Bedford.

Stickland took to the back microphone to cry foul.

“Someone else has chosen to make a mockery of this system and play gotcha politics,” he said before being interrupted. Laughter had erupted in the gallery.

“It’s funny until it happens to you,” he continued.

Springer and Stickland then confronted each other on the middle of the House floor and had to be separated by colleagues. Springer’s amendment ultimately passed, 99 to 26, forcing Stickland to withdraw his own proposal to which it had been attached.

What is best in life is to crush your enemies, see them driven before you, and hear the lamentations of Jonathan Stickland. And Briscoe Cain, too, the Chester to Stickland’s Spike, except without the victorious denouement for Chester. Look, just because the House passed a budget doesn’t mean this is the budget we’ll get. The Senate passed a budget, too, and there are lots of differences to be worked out between the two. The final version will be different, and some of the things we are cheering now may be undone in that. But that’s no reason not to cheer for the things that deserve it now. The Observer and the Press have more.

Senate passes its budget

It’s the one bill that has to pass.

The Texas Senate unanimously approved a two-year budget on Tuesday that would shift nearly $2 billion in public education costs from the state to local taxpayers.

The Senate’s $218 billion document now goes to budget writers in the House for debate.

“This is a lean budget, but it’s also a smart budget,” said state Sen. Jane Nelson, R-Flower Mound, the 2018-19 Senate budget’s lead author. “It responsibly meets the needs of our state.”

The Senate’s proposal would spend $106.3 billion in state revenue, which is a significant bump from the $103.6 billion budget Nelson originally rolled out in January. That puts the Senate’s total spending level much closer to the House’s than they were when the proposals were originally published.

Still, there are major differences in funding priorities and methods of finance that the two chambers will need to reconcile before the Legislature adjourns in May, setting the stage for some of the biggest points of contention this year.

Nelson touted her budget’s focus on education. The Senate proposal actually strips about $1.8 billion in state funds for education but uses local property taxes and other revenue to make up the difference. In total, Nelson said, her proposal would boost public school funding by $4.6 billion compared to the prior budget, including a $2.6 billion provision to cover student enrollment growth.

“Under our formula, the local share of education funding fills up the bucket first, as local property tax collections go up, the state share goes down,” Nelson said. “But in the aggregate, funding for education is going up every year.”

At the same time, the Senate is advancing controversial tax cut proposals that critics say would make it more difficult for the state and local governments to pay for schools. Last week, the upper chamber passed Senate Bill 2, which seeks to curb the growth in property taxes, and Senate Bill 17, which would cut the franchise tax paid by businesses in future years.

Emphasis mine. Note the on-the-nose Trib headline, “Texas Senate approves its budget, shifting school costs to local taxpayers”. Whatever else happens this session, I feel like at least the message that it’s the Legislature that is the main driver of property tax discontent has gotten out. Whether it’s gotten through is another matter, but at least it’s out there. I can’t recall that ever being the case before. The Chron has more on the Senate budget.

Meanwhile, over in the House:

The House Committee on Appropriations unanimously approved a two-year, $218.2 billion budget as a substitute for the Senate’s leaner proposal, putting the chambers on a collision course in the last two months of the session.

HB 1 now heads to the full House for a vote with contrasts to the $217.7 Senate proposal, which the upper chamber approved earlier this week.

House appropriators want to spend $2.5 billion from the Rainy Day Fund in their budget, leaving a $9.4 billion balance. That decision has touched off a public fight between House and Senate budget writers about whether they should dip into the state’s savings account.

On Wednesday, Chairman John Zerwas, a Republican from Katy, took a swipe at the Senate, which signed off on a maneuver that would delay until 2020 the transfer of $2.5 billion for transportation funding that voters approved in 2015.

“This budget does not rely on budget gimmickry that puts the state’s investment in transportation at risk,” he said. “The budget balances by cutting spending, prioritizing critical items and using a modest amount of (the Rainy Day Fund), for the exact purpose for which it is created.”

See here and here for some background on that. The conference committee for this one is going to be very interesting. The Trib has more.

House considers a bigger ask from the Rainy Day Fund

Needs must, as they say.

The proposal from state Rep. John Zerwas, a Richmond Republican and the House’s chief budget writer, would withdraw about $2.4 billion from the Rainy Day Fund as part of a supplemental budget to pay bills coming due for programs like Medicaid, the federal-state insurance program for the poor and disabled, and to pay for repairs to state-run institutions including mental hospitals and the School for the Deaf.

Previously, Zerwas advocated spending about $1.4 billion from the fund, which holds about $10 billion currently. He updated his proposal at Thursday’s meeting of the House Appropriations Committee, saying that without making a “modest withdrawal” from the savings fund, budget writers would be forced to make draconian cuts to public programs.

Entities that face budget cuts absent a cash infusion include the state’s public education system, pensions for retired teachers, and the Texas child welfare and foster care system charged with protecting vulnerable children from abuse and neglect, Zerwas said.

“Some members of our body have said publicly that our situation isn’t really that bad,” he said. “I can’t disagree more with that.”

Most legislative sessions, the Texas Legislature does not fully fund the cost of state programs, so lawmakers must typically pass a supplemental bill to cover the rest. Zerwas’ proposal would net some matching federal dollars, bringing the total value of the bill to $5.2 billion, officials said. About $3 billion would plug funding holes left by lawmakers in 2015, mostly in Medicaid and in a health care program for the state prison system.

The rest would go toward current needs, such as “deferred maintenance” costs at state-run institutions including mental hospitals, many of which are in disrepair.

See here for the background. I approve of Zerwas’ approach and appreciate what he is saying, but I would be remiss if I didn’t point out that a big part of the problem he is trying to solve is self-inflicted. As the story notes, tax cuts passed in the last session, at a time when oil and gas prices were low and the state’s economy wasn’t doing so well, cost $4 billion this biennium, while the referendum to dedicate a portion of sales tax revenue to the state highway fund has taken $5 billion out of the general fund. Zerwas had to file a separate bill to claw some of that money back. These were choices made by the leadership and the Legislature, the former because tax cuts are Republican crack, and the latter because we absolutely, positively refuse to consider raising the gas tax to meet our road needs. Budget gimmicks are just that, and whatever they purport to do, there’s always another gimmick to undo it. As a certain former President once said, reality has a way of asserting itself.

Bill to restore some budget flexibility filed

Call it the Law of Unintended Consequences Act of 2017.

The Texas House’s chief budget writer filed legislation Friday that would allow lawmakers to claw back billions of dollars that voters approved for state highways, freeing them up for other budget needs.

Texans overwhelmingly voted in 2015 to boost funding for the state’s public roadways and bridges, which have strained under a growing population. Proposition 7 amended the Texas Constitution to route some taxes collected on car sales to the State Highway Fund.

But House Appropriations Chairman John Zerwas, R-Richmond, filed a resolution Friday that would cut that initial cash infusion, aiming to free up money at a time when cash is tight.

House Concurrent Resolution 108 could cut the first transfer under Proposition 7 of nearly $5 billion in half, but only if two-thirds of lawmakers in both the House and Senate support such a move.

It’s a prospect made possible by what some lawmakers have called a “safety valve” in Senate Joint Resolution 5, the legislation that the Legislature approved in 2015 to send Proposition 7 to voters later that year.

See here for the background. I don’t expect this to pass – I really don’t think two thirds of the Senate will go for it – but I will be very amused if it does. Whether this is more or less likely to happen than tapping the Rainy Day Fund is now something we can test empirically. If nothing else, that’s a victory for science.

Zerwas proposes using Rainy Day Fund

We’ll see if this goes anywhere.

Rep. John Zerwas

The chief budget writer in the Texas House on Friday proposed using $1.4 billion from the state’s savings account to pay bills coming due for a wide array of the state’s health and human services programs.

The proposal from state Rep. John Zerwas, R-Richmond, would continue pay raises for Child Protective Services workers that state leaders ordered last year. It would also pay for renovations at the state’s aging mental health hospitals and state-supported living centers for people with disabilities.

And it would partially reverse a sweeping $350 million budget cut to a therapy program for children with disabilities ordered by the Texas Legislature in 2015.

The funding would come from the state’s Economic Stabilization Fund, also known as the Rainy Day Fund, a savings account lawmakers may use in tight budget years. That fund currently has about $10 billion.

“Using a small portion of the Economic Stabilization Fund, combined with spending reductions, is the responsible way for us to close out the current budget cycle and respond to the slowdown in our economy,” Zerwas said in a prepared statement.

This is for the supplemental budget, which is to say the budget passed by the 2015 Legislature, not for the one this Lege is working on. It will free up some money for the current budget if Zerwas’ proposal is adopted, in the sense that current revenues would not have to be used to close out the previous budget. Given the emergency that everyone agrees CPS is and the outcry that followed the cuts to the therapy program for children with disabilities, you would think this would be a relative no-brainer, but don’t count on it. The Rainy Day Fund morphed from being a tool to use to smooth out economic bumps to a lump of gold buried in the backyard that is never to be touched unless there’s a natural disaster, with the 2011 session in which cutting $5 billion from public education was seen as the better choice as the turning point. A supermajority is needed to tap the Rainy Day Fund, and I have a hard time believing Dan Patrick and his Senate sycophants will go for that. But at least someone had the guts to bring it up, so kudos to Rep. Zerwas for that. Keep an eye on this, because it may be a precursor of the larger budget fight between the chambers. If Zerwas gets his way, that bodes well. If not, things could get ugly.

Precinct analysis: Fort Bend State Rep districts

Following on from yesterday’s post, here’s a look at the vote in Fort Bend from the perspective of the State Rep districts.


Office	            Rep    Dem    Rep %   Dem %
===============================================
President        35,005  31,558  52.59%  47.41%
CJ, 1st CofA     40,047  28,336  58.56%  41.44%
1st CofA #4      39,311  28,940  57.60%  42.40%
14th CofA #2     39,351  28,873  57.68%  42.32%
14th CofA #9     40,008  28,185  58.67%  41.33%
240th JD         39,743  28,291  58.42%  41.58%
400th JD         39,954  28,130  58.68%  41.32%
County Court #5  39,194  28,774  57.67%  42.33%
Sheriff          41,342  27,454  60.09%  39.91%
HD26             39,672  28,876  57.87%  42.13%
President 08     39,210  24,076  61.96%  38.04%
President 12     39,595  22,554  63.71%  36.29%


Office	            Rep    Dem    Rep %   Dem %
===============================================
President        18,471  47,471  28.01%  71.99%
CJ, 1st CofA     21,234  46,194  31.49%  68.51%
1st CofA #4      20,732  46,629  30.78%  69.22%
14th CofA #2     20,635  46,766  30.62%  69.38%
14th CofA #9     21,235  46,072  31.55%  68.45%
240th JD         20,912  46,159  31.18%  68.82%
400th JD         20,999  46,161  31.27%  68.73%
County Court #5  20,590  46,422  30.73%  69.27%
Sheriff          21,147  46,215  31.39%  68.61%
HD27             21,531  45,648  32.05%  67.95%
President 08     18,186  42,374  30.03%  69.97%
President 12     18,939  42,811  30.67%  69.33%


Office	            Rep    Dem    Rep %   Dem %
===============================================
President        44,604  36,032  55.32%  44.68%
CJ, 1st CofA     50,370  33,133  60.32%  39.68%
1st CofA #4      49,824  33,595  59.73%  40.27%
14th CofA #2     49,791  33,655  59.67%  40.33%
14th CofA #9     50,503  32,857  60.58%  39.42%
240th JD         50,064  32,972  60.29%  39.71%
400th JD         50,238  32,827  60.48%  39.52%
County Court #5  49,563  33,405  59.74%  40.26%
Sheriff          51,110  32,457  61.16%  38.84%
HD28             56,777       0 100.00%   0.00%
President 08     30,636  21,813  58.41%  41.59%
President 12     40,593  22,001  64.85%  35.15%


Office	            Rep    Dem    Rep %   Dem %
===============================================
President        19,132  19,414  49.63%  50.37%
CJ, 1st CofA     20,705  18,695  52.55%  47.45%
1st CofA #4      20,563  18,773  52.28%  47.72%
14th CofA #2     20,484  18,845  52.08%  47.92%
14th CofA #9     20,795  18,524  52.89%  47.11%
240th JD         20,864  18,405  53.13%  46.87%
400th JD         21,064  18,238  53.60%  46.40%
County Court #5  20,502  18,726  52.26%  47.74%
Sheriff          21,365  18,214  53.98%  46.02%
HD85             20,876  18,539  52.96%  47.04%
President 08     28,328  19,638  59.06%  40.94%
President 12     30,652  19,087  61.63%  38.37%

I want to begin by noting that HD85 is only partly in Fort Bend; it also encompasses Jackson and Wharton counties. I have no explanation for why the Republican vote dropped off by 10K from 2012 while the Democratic vote has held more or less steady over the past three elections. I didn’t include the 2012 and 2008 Presidential numbers when I first drafted this post, so I wouldn’t have even noticed that had I not added them in later. Maybe there are fewer people in the district? I have no idea. Feel free to enlighten me in the comments.

HD26 is the revelation here. It’s never been on anyone’s radar as being potentially competitive, having been drawn as a 62% or so Republican district in 2011. What appears to be happening is that much like Commissioner’s Precinct 4, HD26 gained Democratic voters, about 6,000 of them over 2012, without gaining any Republican voters. This is not a coincidence, as 26 of the 41 voting precincts in HD26 are in CC4, so the fortunes of the two are clearly correlated. The non-Presidential numbers don’t really qualify HD26 as a swing district, but the trend is in the right direction, and if 2018 winds up a lower turnout year for Republicans, this could interesting. And while I’ve consistently downplayed the Presidential numbers in various contexts, one does have to wonder if a Republican who was persuaded to vote for Hillary Clinton in 2016 might be open to the possibility of voting for a good Democratic candidate against a Trump-supporting Republican officeholder in 2018. The more we can test messages that might move the needle a point or two, the better. Whatever the case, even if 2018 is too soon for demographic change to make HD26 competitive, 2020 may not be. And remember that overlap between Commissioner’s Precinct 4 and HD26. A good candidate in one race can help the other, and vice versa.

Neither HDs 27 nor 28 are competitive, and neither are all that interesting to look at from this view. HD28 is clearly the fast-growing part of Fort Bend – it mostly overlaps with Commissioner’s Precinct 3, in case you were wondering. Turnout has increased by over 60% in HD28 since 2008. Democrats have kept up since 2012, but are behind overall from 2008. My guess is that if redistricting were to be done today, HD28 would be used to shore up HD26, while perhaps also dumping some Democrats into HD27, which hasn’t grown much. I don’t see HD28 becoming competitive based on what we observe here, but as a population center it’s imperative for Dems to engage here, because this area will have an outsized impact on countywide races. You have to keep the margin here manageable, and make sure that new residents who lean Democratic are aware that their votes are needed even if their local races aren’t really winnable.

House approves limited medical marijuana bill

And there it is.

On a 96-34 vote, the House passed Senate Bill 339, from state Sen. Kevin Eltife, R-Tyler, which would legalize oils containing CBD, a non-euphoric component of marijuana known to treat epilepsy and other chronic medical conditions. If the House gives final passage in a follow-up vote, the measure will be Gov. Greg Abbott’s to sign, veto or allow to become law without his signature. If it becomes law, the state would be able to regulate and distribute the oils to patients whose symptoms have not responded to federally approved medication.

Before the vote, state Rep. Stephanie Klick, R-Fort Worth, the bill’s House sponsor, repeatedly stressed to House members that the product she was trying to legalize should not be confused with marijuana.

“It is also not something you can get high on. It has a low risk of abuse,” Klick said. “This is not something that can be smoked. It is ingested orally.”

[…]

Several Republican lawmakers brought up those concerns during the House floor debate. At one point, over the shouts of House members booing, state Rep. Mark Keough, R-The Woodlands, yelled, “This is a bad bill.”

State Rep. John Zerwas, R-Simonton, and a House sponsor of the bill along with Klick, responded. “It is not a bad bill. It is a great bill and it is going to save lives.”

See here for the background. This is not a bad bill, but it’s not a great bill, either. It should do some good, and it’s a step in the right direction, but remember that some CBD proponents opposed this bill because it didn’t do very much for them. I hope the Lege is as kind to Rep. Joe Moody’s bill to reduce marijuana penalties, but if this is all we get, I won’t be surprised. A statement from RAMP is beneath the fold, and Trail Blazers and the Current have more.

(more…)

Call to action: DREAM Act repeal hearing set for Monday

You know the drill.

The push to repeal a 2001 law that allows some undocumented students to pay in-state tuition at public colleges and universities is returning to the legislative spotlight, but on an unusual stage.

On Monday, the border security subcommittee of the Senate’s Veteran Affairs and Military Installations Committee is scheduled to hear Senate Bill 1819, by state Sen. Donna Campbell, R-New Braunfels, which would do away with the in-state tuition provision.

Lt. Gov. Dan Patrick’s decision to send the bill to the border security panel — instead of the education or state affairs committees — strikes some lawmakers as a signal that the deck is being stacked in its favor.

State Sen. José Rodríguez, D-El Paso, said treating tuition rates as a question of border security was also an affront to undocumented students pursuing college degrees.

“Referring in-state tuition repeal to border security is implying these students are threats to the country, when in fact they are trying to contribute to the country,” he said. “It is a disservice for this bill to be heard in border security.”

Monday’s hearing was scheduled on Wednesday, a week after a similar bill, SB 1429 by state Sen. Bob Hall, R-Edgewood, was referred to the Senate’s State Affairs Committee. But as of Thursday, Hall’s bill hadn’t been scheduled for a hearing. (Patrick’s office declined to shed light on why Campbell’s bill was referred to the subcommittee and immediately considered.)

But while the measure is likely to easily pass the Senate, it may meet more resistance in the House.

[…]

When the session began in January, state Rep. John Zerwas, R-Richmond, said he supports the current policy despite the political firestorm it’s caused. On Wednesday, Zerwas, chairman of the House Higher Education Committee, said debating the policy is healthy, but he still stands behind it.

If SB 1819 passes the Senate, Zerwas said it likely won’t be referred to his committee but instead the House Committee on State Affairs. The chairman of that committee, state Rep. Byron Cook, R-Corsicana, said his support for the current policy is double-tiered.

“Number one, Texas made a commitment to these students, and as Texans we should honor our word,” he said. “Additionally, it would seem to me that having educated young people is much more productive for the economy of the state.”

Good for you, Reps. Zerwas and Cook. As for Donna Campbell, she’s doing her best to become Debbie Riddle 2.0. Details for Monday’s hearing are here; it was originally scheduled for last Monday but was postponed for a week. If it’s at all possible for you to be there and voice your opposition, please do so.

Texas Obamacare enrollments top 850K

And counting.

It's constitutional - deal with it

It’s constitutional – deal with it

Officials at the Department of Health and Human Services Wednesday announced nearly 860,000 Texans so far have enrolled in health insurance marketplace coverage with a month left still left to go until the 2015 open enrollment period ends.

It’s unclear how many of those signups are new marketplace customers. Last year, nearly 734,000 Texans, many of whom had never been insured, signed up for coverage. About 198,000 of them were in the Houston area.

“As of Jan. 9, 859,377 Texans have access to quality, affordable health coverage for 2015 through the Health Insurance Marketplace,” said Health and Human Services Secretary Sylvia Burwell in a written statement.

Good to hear. National enrollments have been strong as well. It seems eminently reasonable to me that Texas could top one million signups by February 15, given the likelihood (as was the case last year) of some number of people waiting till the last minute to get it done.

There’s also an intensified focus on the Latino community.

Officials plan more than 600 enrollment events nationwide, including a few in the Houston area, that target Hispanics in an effort to get more signed up for coverage under the Affordable Care Act. In the meantime, grass-roots organizations and the Department of Health and Human Services are spreading the word about the marketplace by using webinars, Twitter, advertising and Spanish television telethons.

“We’re doubling down,” Health and Human Services Secretary Sylvia Burwell told reporters Wednesday, noting that the agency has dedicated a third of its advertising budget to Spanish speakers. “The Latino community is one of the fastest growing communities in the country. We’re specifically focused on this community because of the health disparities that exist for them and we think having insurance will help.”

[…]

Researchers have found Texas Latinos were more than twice as likely as Anglos to enroll in marketplace coverage. They also discovered Hispanic adults in Texas have more difficulty affording health care and are three times as likely to be uninsured.

Burwell repeatedly has said Spanish speakers would be targeted for more outreach this enrollment period. Insurers and enrollment organization trained more application assisters to accommodate Latino applicants and marketplace officials simplified the insurance application process, expanded the number of documents people could use to verify their identities and income and made it easier for applicants to use hyphenated names, which are common in Latino communities.

“We’re working to meet Latino consumers where they are, whether that’s online, over the phone or in person,” Burwell said.

There’s a lot of potential there, and one thing we learned from the first round of enrollments was precisely that these customers needed more engagement to get signed up. I hope this has the desired effect, and that we can learn more for the next time.

What would happen to all these people if SCOTUS takes the opportunity to gut subsidies for the national exchange? My guess is that as are the million or so folks that would qualify for Medicaid under a normal expansion plan, they’d be SOL. Oh, I’m sure that Rep. John Zerwas will put forth a bill to create a Texas state exchange, as he has done before. He’ll have the support of all the Dems, a few honorable Republicans, every non-crazy local official, and the business establishment, but it won’t be enough. Nothing will change till we start to win more elections. I wish I had a sunnier outlook than that, but I don’t. Sorry.

What’s the Lege going to do with the revenue?

Not as much as it should, of course, because the Lege never comes close to doing as much as it should. It’s a question of whether they’ll try to address some real problems, or just engage in an orgy of tax cutting.

BagOfMoney

Texans can expect tax relief, a laser focus on border security and more efforts to fight traffic congestion when a cash-flush Legislature convenes in January.

The budget priorities line up with campaign promises from Republican state leaders and lawmakers, who handily won their spots with a message of keeping state government lean while carefully weighing any additional spending for its benefits.

At least some outnumbered Democrats also appear to be on the tax-relief bandwagon, as the state welcomes the prospect of having $5 billion or more in greater-than-expected revenue when the current two-year budget period ends. Anticipated economic growth is expected to yield billions more, with the caveat that uncertain oil prices must temper expectations.

The tax-relief issue “crosses party lines,” said Senate Finance Committee Chair Jane Nelson, R-Flower Mound. “Property taxes are really something that people would like to address.”

Besides property-tax relief – pushed by Sen. Dan Patrick, the incoming lieutenant governor – the potential for cutting the state’s business tax has been highlighted by Attorney General Greg Abbott, the governor-elect.

The devil, as always, is in the details of a state budget that totals $200 billion in the current two-year fiscal period, including state and federal funds that are largely spoken for before lawmakers convene. Education and health and human services alone take up nearly three-quarters of the total.

“I fully expect there to be some tax relief. The question is, what’s the nature of it?” said Rep. John Otto, a Dayton Republican who serves on the House Appropriations Committee.

[…]

What’s clear is that despite the billions of greater-than-predicted dollars awaiting lawmakers’ allocation, the list of programs that can use more money is far longer than the dollars can cover, especially in light of a spending cap on certain general revenue.

“It’s sort of easy when there’s not a lot of money. You just say we haven’t got the money,” said Rep. John Zerwas, a Richmond Republican who serves on the House Appropriations Committee. “Whereas now, I call it kind of a food fight. You’ve got a lot of food on the table, and people are going to start grabbing for it and trying to make sure they get their programs funded at a level that they want.”

Simply keeping current levels of services to a growing population would cost an additional $6 billion to $7 billion in state general revenue, said Eva De Luna Castro of the Center for Public Policy Priorities, which focuses on services important to middle- and lower-income Texans. That’s without addressing the lingering cuts from 2011.

“All we’re hearing about is tax cuts. Nobody is talking about, ‘What did we cut out of the budget in 2011?’ ” she said. “I don’t think it’s exaggerating to say that our future economy and prosperity are at stake. We need good roads but we also need good schools and universities.”

If you think that last bit is just the usual liberal happy talk, you should see what the Texas Association of Business’ wish list for the legislative session looks like. They expect to spend the next six to eight months fighting against the people they just supported for election on these issues, because that’s how they roll. “Border security” is a huge boondoggle for which all indicators are always that we should keep doing what we’ve been doing, which is to say to spend more and more and more on it. And no, the feds aren’t going to cover that check no matter how nicely Greg Abbott asks the President for it. As for property tax “relief”, the proposals put forth by Sen. Kirk Watson and others to increase the homestead exemption would be the most equitable way of doing this, which means it is also the least likely way of it happening. But I suppose anything is still possible before the session begins, just like the possibility than your favorite NFL team can go 16-0 while training camp is still going on. We’ll see what happens when the games start getting played for real.

It’s still not Medicaid expansion

The Legislature may do something that could sort of be called “Medicaid expansion”, if only for lack of a better term, but we would all do well to remain deeply skeptical of what they might consider.

It's constitutional - deal with it

It’s constitutional – deal with it

The once taboo subject of expanding Medicaid in Texas has been broached in recent weeks by some Republicans and GOP-friendly organizations, as the Legislature prepares to reconvene early next year.

[…]

In 2013, state Rep. John Zerwas, R-Richmond, wanted to use federal dollars and a Medicaid waiver to create a new insurance program for poor Texans, but he was never able to build much support among his Republican colleagues.

“Last time, everybody was pretty reactionary,” said Zerwas, a physician. “We were playing defense.”

But with Perry leaving office in January and a new legislative session set to begin, Zerwas and his allies once again are pushing for a new program.

The difference this time is the dialogue is more thoughtful and the effort is more organized, he said.

Zerwas and other legislators had the chance after the 2013 session to go back to their districts and listen to their constituents. Many expressed interest in insuring people who can’t get coverage under the new law, he said, but many more have indicated that they want to see the already stressed, safety-net hospitals get some relief from being forced to care for so many uninsured people.

Gov.-elect Greg Abbott said on the campaign trail that he opposed Medicaid expansion, but spoke of seeking a block grant from the federal government to reform Medicaid in the state, echoing some other Texas Republicans.

The words “block grant” are your first clue that despite the sincere words of people like Rep. Zerwas, this is the same old song and dance with some fresh wrapping paper on it. Block grants are a shibboleth and a mirage. The Bush administration refused to grant waivers to allow for these things. President Obama will nominate Ted Cruz to be its next Attorney General before his administration will consent to block grants for Texas.

The Texas Association of Business, an influential group with close friends in the Republican Party, has come out again in support of expanding Medicaid, just as it did in 2013.

Bill Hammond, president of the organization, said it will take a “massive effort” in 2015 to increase coverage for Texans, but it’s a fight he is willing to take on.

“It just makes sense for us from the business perspective,” he said.

[…]

Dan Stultz, president and CEO of the Texas Hospital Association, said in a presentation that hospitals need meaningful coverage expansion.

Stultz told the Associated Press earlier this year that hospitals agree with Perry that the Medicaid program is “severely flawed,” but he also said that “without the Medicaid expansion, many will remain uninsured, seeking care in emergency rooms, shifting costs to the privately insured and increasing uncompensated care to health care providers.”

The Texas Medical Association, one of the most powerful lobbies in state government, also supports allowing state leaders to work with the federal Centers for Medicare and Medicaid Services to come up with a solution that fits Texas’ health care needs.

The association’s leaders are pushing the Legislature to create a concept, as it says on the group’s website, that “works for the state and helps Texans in the coverage gap get affordable and timely care.”

The “support” these organizations have for Medicaid expansion doesn’t extend to supporting candidates that support Medicaid expansion, of course. In that way, it’s like their support of immigration reform. Fill in your own definition of insanity, and go search healthcare.gov for insurance policies that would cover that affliction.

Be all that as it may, we now have an interim report with recommendations on the subject.

Texas should pursue a waiver from the federal government for more flexibility to administer Medicaid, heighten the “visibility” of the state’s mental health programs to “ensure adequate leadership and accountability” and consolidate its three major women’s health programs, the Senate Committee on Health and Human Services said Monday.

In a lengthy report, the interim committee released its recommendations for the 2015 legislative session, addressing charges from outgoing Lt. Gov. David Dewhurst to expand access to women’s healthcare, improve the state’s mental health services, stop prescription drug abuse, and provide affordable care options for the state’s uninsured — all under the constraints of a fiscally conservative budget.

[…]

Among the report’s other recommendations:

Texas should not expand Medicaid to cover low-income adults, a key tenet of federal health law. Lawmakers should, however, seek to renew the “transformational” Medicaid waiver that, among other things, helps reimburse hospitals for the emergency care they provide to the uninsured. Notably, the report does not rule out pursuing a transformational waiver like the one the feds approved in Arkansas, which provided for a private health coverage expansion to low-income people using the Medicaid expansion dollars made available under the Affordable Care Act.

See here for some background, and here for a copy of the report. Rather than get distracted by shiny objects, read these two paragraphs from page 23:

The state’s first order of business must be to repair this broken Medicaid system and bring these costs under control. By enacting common-sense reforms such as cost sharing, health savings accounts, variable benefit packages, and high-deductible emergency care plans, Texas can reform its Medicaid program in a way which contains costs, encourages personal responsibility, and lessens the burden of providing uncompensated care.

Unfortunately, most of these innovative solutions are not able to be implemented under the strict Medicaid guidelines imposed by the federal government. By receiving a federal waiver from these restrictions, Texas can finally have the flexibility it needs to design a sustainable and cost-effective Medicaid program that is appropriate for the citizens it serves and accountable to taxpayers.

Like I said, let’s keep our eyes on the ball. The feds have been making noise about that “transformational” waiver not being a guarantee if Medicaid isn’t expanded in some acceptable form. What “acceptable” looks like is the hundred billion dollar question. The feds have been fairly accommodating to recalcitrant states, but there’s only so far they’ll go. Block grants ain’t happening, and those pet rocks masquerading as “common sense reforms” are more smoke than substance. Texas is going to have to give something to get something, and I’ll believe that will happen when I see it. A press release from Sen. Charles Schwertner, the chair of the HHS committee, is here, and Texans Together has more.

Expand Medicaid or else

Turns out the federal government has more leverage over Texas than you might think.

It's constitutional - deal with it

It’s constitutional – deal with it

If Texas wants to keep receiving billions of federal dollars to help hospitals care for uninsured patients, state lawmakers may have to look again at expanding Medicaid coverage for impoverished adults, some political observers say.

That’s because in 2016, Texas will have to ask the federal Centers for Medicare and Medicaid Services to renew a five-year waiver to pump $29 billion into state health care coffers.

Since landing its first such waiver in 2011, Texas leaders have defiantly refused to expand Medicaid as envisioned under the Affordable Care Act, leaving more than 1 million impoverished Texans with no health insurance.

With the waiver renewal nigh, observers said, there’s some expectation that the federal agency will hold the waiver approval hostage in exchange for Medicaid expansion.

“CMS is going to hold that over Texas’ head to say, ‘You want this money? You do the expansion,’” said Matt Salo, executive director of the National Association of Medicaid Directors. “It’s one of the points of leverage that CMS now has.”

Texas received the 2011 Medicaid waiver in part to reimburse hospitals for care provided to patients who couldn’t pay. Two years later, state leaders under Gov. Rick Perry declined to expand Medicaid, criticizing the program as inefficient.

That left a “coverage gap” of more than 1 million Texans too poor to receive federal subsidies for private health insurance but too rich to qualify for coverage under Texas’ current, restrictive Medicaid requirements.

Now, policy analysts on the left and right say, the feds are likely to be less sympathetic to Texas’ request for another waiver to help pay for uncompensated care.

A similar tug-of-war is playing out in Florida, said Joan Alker, executive director at the Center for Children and Families at Georgetown University. In May, the federal government renewed Florida’s waiver to reimburse hospitals for just one year, rather than the standard three, “which was very unusual,” Alker said.

[…]

State Rep. John Zerwas, R-Richmond, one of the lawmakers who advocated for the “Texas solution,” said the Legislature would revisit coverage expansion during the session.

“It still behooves us as a Legislature to figure out, what’s the policy going to be around these people?” he said. “I’ll be the first to say that finding a solution for these million and a half people is important.”

And the transformational waiver from 2011 is already a source of some conflict with the federal government. CMS is currently withholding $75 million in waiver money that Texas used to reimburse private hospitals while federal officials review whether any rules were broken.

Tiffany Hogue, policy director for the Texas Organizing Project, which has worked to get Texans to sign up for health coverage on the exchange, said Medicaid expansion would be a top priority for her group during the legislative session.

“It’s absolutely going to be a battle cry for us,” she said. “The sheer number of uninsured — that’s daunting.”

Still, Alker said she was skeptical that Texas would expand Medicaid anytime soon.

“I remind myself when the Children’s Health Insurance Program was passed in 1997, Texas was the last state in the country to pick up the program,” she said. “That may be instructive moving forward.”

It’s always a safe bet to assume that the Legislature will fail to do the right thing when given the chance. I for one will be rooting for the feds to apply the screws as hard as they can in pursuit of a Medicaid expansion deal that would do untold amounts of good for more than a million people, not to mention be a nice bit of stimulus for the Texas economy. Making Ted Cruz’s head explode would be the cherry on top. Against that, when the Republicans from Greg Abbott on down (with the honorable exceptions of Zerwas et al) dig their heels in, perhaps this will finally be the impetus to get the Texas Medical Association to quit trying to placate the bullies and start working to actually further their own and their patients’ best interests.

LVdP for Medicaid expansion

No surprise here.

Sen. Leticia Van de Putte

Sen. Leticia Van de Putte

Democratic state Sen. Leticia Van de Putte vowed to overturn Republican opposition to expanding the state’s Medicaid program under the Affordable Care Act if elected lieutenant governor, saying the state should act to protect poor, uninsured adults.

The San Antonio Democrat’s “Texas First Health Care Plan,” which she announced Friday at the Davila Pharmacy in San Antonio where she works as a pharmacist, attempts to close the coverage gap created when Texas lawmakers refused to expand Medicaid eligibility under the federal health reform law. She says expanding Medicaid is the “right choice” for the sky-high rate of uninsured Texans.

“As lieutenant governor, I’ll forge a Texas solution to draw down federal funds back to Texas taxpayers, protect Texas businesses, and expand access to affordable health care in our state,” Van de Putte said in a statement. “One out of every four Texans lacks health insurance. That system is unsustainable, bad for business, and bad for Texas families.

She contends that changing the state’s Medicaid program to insure poor adults — a feat that would require Republican support in the Legislature — could include cost-sharing between the state and beneficiaries, consisting of co-pays, income-based premiums on health plans, or using federal funds to purchase private insurance.

I’ll spare you the usual litany of why Medicaid expansion, or some other-named facsimile of Medicaid expansion, is a good idea. I will note that while Wendy Davis is busy frying other fish, she is also out there on the stump talking Medicaid expansion, too (via). Interestingly, it seems that Republican governors in other states that have expanded Medicaid in some form are doing better in the polls than their counterparts who refused. I don’t know that you can draw any broad conclusions from that, but better than if it were the other way around.

One has to wonder how this might play out if Davis and VdP get elected. We know there was a faction of Republicans in the Legislature, epitomized by Rep. John Zerwas, that wanted to find some kind of Medicaid expansion solution that could be called something else and contained at least a couple of conservative wish list items but which would be acceptable to the Obama administration and would allow the billions that Texas would receive to start flowing. They never got anywhere because of Rick Perry’s rigid ideological stance, but they tried. Would they be able to get something pushed through for Governor Davis to sign, or would the nihilist faction react with the same ferocity that Congressional Republicans showed President Obama and shut them down? Unfortunately, I suspect the latter is more likely, but that’s no reason not to elect Davis and Van de Putte and give it a try. It’s not like electing Abbott and Patrick will placate those folks and make them sit back placidly while the Lege goes about its normal business.

Don’t sweat that court ruling on Obamacare tax credits just yet

It’s too soon to say what effect, if any will be felt in Texas.

It's constitutional - deal with it

It’s constitutional – deal with it

Opposing rulings from two federal courts Tuesday left unclear the future prospects of federal financial aid to Texans who qualify for assistance to purchase health insurance under the Affordable Care Act.

The U.S. Court of Appeals for the D.C. Circuit ruled that the ACA legislation made federal subsidies available only to individuals who purchased insurance through state-run exchanges. That would make federal subsidies illegal in the 36 states, including Texas, that use the federally facilitated insurance marketplace.

That announcement was followed by a decision from the 4th Circuit Court of Appeals in Virginia, which ruled that individuals who enroll using federally facilitated exchanges are eligible to receive subsidies.

Texas, like dozens of other states with Republican leaders, declined to create its own state-based insurance exchange under the ACA. Instead, Texas relies on a federally managed marketplace. More than 730,000 Texans enrolled for health coverage through the federal marketplace during the first period of open enrollment.

[…]

Individuals whose annual incomes range from one to four times the federal poverty level — $11,490 to $45,960 for an individual and $23,550 to $94,200 for a family of four — typically qualify for the subsidies.

Christine Sinatra, state spokeswoman for Enroll America, which has worked to enroll individuals in the federal marketplace, said the availability of financial assistance was “obviously a big factor” for that encouraged many in Texas to get insurance.

“What’s most important at this stage is for consumers to know that no one will lose their coverage or their financial help while this judicial process plays out,” Sinatra said. “And today’s decision isn’t making anyone newly uninsured.”

As noted in the story, some 734K people signed up for insurance via the federal exchange, and they generally got a good deal when they did. Put that aside for now, because as Josh Marshall suggests, the en banc reviews are likely to result in both courts agreeing, in which case there’s no dispute for the Supreme Court to resolve. But they could still take the case, or maybe something goes sideways with the en banc reviews. What happens if the adverse ruling is ultimately upheld? Kevin Drum suggests one possibility.

The key point here is that people respond much more strongly to losing things than they do to not getting them in the first place. For example, there are lots of poor people in red states who currently aren’t receiving Medicaid benefits thanks to their states’ refusal to participate in Obamacare’s Medicaid expansion. This hasn’t caused a revolt because nothing was taken away. They just never got Medicaid in the first place.

The subsidies would be a different story. You’d have roughly 6 million people who would suddenly lose a benefit that they’ve come to value highly. This would cause a huge backlash. It’s hard to say if this would be enough to move Congress to action, but I think this is nonetheless the basic lay of the land. Obamacare wouldn’t be destroyed, it would merely be taken away from a lot of people who are currently benefiting from it. They’d fight to get it back, and that changes the political calculus.

Six million people nationwide, 734,000 in Texas. Remember, while it would take Congress to fix the national problem if it comes to that, there’s nothing stopping Texas or any other state from setting up their own exchange, as the law (as interpreted by two federal judges in Washington, DC) says. State Rep. John Zerwas tried to pass a bill in 2011 to establish an exchange in Texas, on the very reasonable grounds that a state-run exchange would be a better fit than a national one would. Sadly, though not surprisingly, it went nowhere, thanks in large part to Rick Perry’s fanatical opposition. My point is that if Drum is right then any pressure on Congress to fix this would also translate to the state Legislature. Who knows what effect that might have in 2016, or even 2018? Or for that matter, how about this year, too? Seven hundred thousand people losing something that they now have, that sure is a lot. Surely there’s something we can do with that.

More on Texas Left Me Out

The Observer reports on the launch of Texas Left Me Out.

Members of the coalition pointed to two different studies that estimate that thousands of uninsured Texans with chronic conditions are likely to die as a result of not expanding Medicaid.

A Harvard University/CUNY study released last week predicts between 1,840 to 3,035 deaths. Another study, by a University of Texas Medical Branch researcher, projected approximately 9,000 preventable deaths per year. Dr. Robert Luedecke of Doctors for America, a national coalition for healthcare reform, said the death toll associated with the uninsured is something many lawmakers won’t talk about.

“What would people do if they didn’t have health insurance?” Luedecke said of critically ill patients who put off seeing a doctor because they can’t afford it. “They would just die—that’s what they’d do.”

Linda Berman, 63, is one of those who says she’s been left out by Texas. She’s languishing in the coverage gap while dealing with diabetes and high-blood pressure. As a small business owner teaching Science, Technology, Engineering and Mathematics (STEM) skills to kids through a traveling workshop, Berman said she’s left with little to no taxable income at the end of the year. The cheapest individual private plan she’s found comes with a $450 monthly premium—out of her price range. She makes too little to qualify for subsidies on the marketplace and she’s never been eligible for Medicaid under Texas’ strict eligibility standards. Two years ago, Berman racked up $70,000 in medical debt after she was hospitalized.

“I knew I had no money to pay for [the visit] but had I not [paid out of pocket], they wouldn’t have saved my life,” Berman said.

Not long after her hospitalization, a debt counselor told her that she would never be able to pay off her medical debts. Berman soon filed for bankruptcy. The hospital was left holding the bill.

“People without insurance don’t get preventative care,” Berman said. “You don’t die of diabetes, you die of complications.”

See here and here for the background. The Trib also tells Ms. Berman’s story, and adds this extra bit of context to the situation.

State Rep. John Zerwas, R-Richmond, who led efforts to craft “a Texas solution,” said he hoped that the period between legislative sessions would give lawmakers a chance to work on a road for reform. However, he said he wasn’t sure that this particular coalition would have a significant impact, and he said a coalition of businesses concerned with health care issues would have a stronger impact. He said a business-focused coalition would “resonate especially with the conservative Legislature.”

Texas has declined billions of dollars from the federal government to assist with Medicaid expansion and will lose $100 billion in federal funds over a 10-year span, according to a report by Billy Hamilton, a tax consultant and former deputy comptroller, for Texas Impact and Methodist Healthcare Ministries of South Texas Inc. The federal government would cover 100 percent of the Medicaid expansion enrollees’ health care costs from 2014 to 2016, then gradually lower its share of the costs to 90 percent over ten years, resulting in 10 percent of financial responsibility for the state by 2020.

The Texas Association of Business, local government officials, and the state’s largest medical associations, including the Texas Hospital Association, and Texas Medical Association, pushed lawmakers to expand Medicaid during the 2013 session, but the issue still failed to gain traction among Texas’ conservative leadership.

Rep. Zerwas has been an honorable actor in this saga, but I don’t know what he’s talking about here. Look at that last paragraph and the supporters of Medicaid expansion in it. If that’s not a sufficiently business-focused coalition to resonate with the Lege, who else is there? We need a change of leadership at the top. That’s the only way this is moving forward.

Arkansas will expand Medicaid

If they can do it

It's constitutional - deal with it

It’s constitutional – deal with it

[Friday], the Center for Medicaid and Medicare Services notified state officials in Arkansas that it has approved the states’ Medicaid expansion plan. And this is not any old expansion plan: Arkansas will be the only state in the country that will use Medicaid dollars to purchase private health insurance for its new public program enrollees.

“CMS is pleased to approve Arkansas’s Medicaid 1115 Waiver application,” Medicare spokeswoman Emma Sandoe said in a statement. “Arkansas and CMS worked together to find flexibilities that gave the state the tools to build a program that worked for them and their residents. We appreciate the collaboration with Arkansas throughout the process and applaud their commitment to providing Arkansans with access to high-quality health coverage.”

There are about 200,000 Arkansans who qualify for the Medicaid expansion. Instead of having them enroll in the public program, like other states will do, Arkansas will send them to their new health insurance marketplace to buy individual plans. When they get to the point of purchase, the Medicaid agency will foot the tab for their health insurance coverage.

The Arkansas expansion will start open enrollment just five days from now, on Oct. 1, alongside the 25 other states planning to expand the program. Benefits will begin Jan. 1.

The idea of using Medicaid expansion funds to pay for private insurance for those that would have qualified for Medicaid under Affordable Care Act expansion guidelines was proposed earlier this year, while the Lege was in its first session. House Speaker Joe Straus seemed open to this kind of idea, but he had precious little company on his side of the aisle. The quasi-Medicaid “expansion” bill that made it out of the House before withering on the vine insisted on asking for a block grant first, as that is Rick Perry’s obsession, but maybe – MAYBE – once that door is slammed shut again there will be some willingness to look at this plan again, however imperfect it is.

Texas really needs Obamacare

We’ve always known that Texas would be a huge beneficiary of the Affordable Care Act because of our huge volume of uninsured people, but this quantifies it in a way that really brings it home.

It's constitutional - deal with it

It’s constitutional – deal with it

Texas is home to more than two-thirds of the nation’s 30 counties most in need of expanded health insurance coverage, according to a liberal group.

The Center for American Progress Action Fund ranked 22 Texas counties – including Dallas — as among the “30 worst” in the country, citing residents’ lack of insurance and poor health outcomes, such as heart attack deaths.

In a report released Thursday, the advocacy group said many Republican U.S. House members “are doing everything they can to torpedo” the federal health law despite having many constituents who would benefit from new state health marketplaces that will open on Oct. 1.

Dallas County, with 31 percent of residents uninsured, had the 14th-worst rate of health coverage among U.S. counties with more than 25,000 people, the report said.

Forty-five percent of Dallas County’s young adults — ages 18 to 39 – lacked insurance in 2011. Nine percent of all county residents have diabetes, which is a rate 13 percent higher than the national average, the group found. Nearly 15 of every 100,000 county residents die each year from stroke. That rate is 26 percent higher than the national average.

“There are just enormous human and economic inefficiencies from [having] a large number of uninsured persons in any county,” Tom Perriello, the group’s chief and a former Democratic congressman from Virginia, said in a media conference call.

While several of the Texas counties on the worst list are along the U.S.-Mexico border, the 22 were scattered in all regions of the state.

The report is here and the summary of it is here. What they did was rank the counties on six different factors:

  • Highest overall percentage of uninsured individuals under age 65
  • Highest percentage of uninsured women under age 65
  • Highest percentage of uninsured individuals ages 18 to 39
  • Highest percentage of uninsured young men
  • Highest percentage of uninsured people of color
  • Highest percentage of uninsured working-class individuals

The “bottom 30” list was then taken from the counties that did the worst overall on all six factors. Harris County scored among the worst on “Highest overall percentage of uninsured individuals” (#19, 29.9%); “Highest percentage of uninsured women under age 65” (#18, 28.8%); “Highest percentage of uninsured individuals ages 18 to 39” (#40, 43.1%); and “Highest percentage of uninsured working-class individuals” (#9, 34.2%), where that is defined as “individuals between 18 and 65 earning between 138% and 400% of the Federal Poverty Line”.

The good news is that despite the Republicans’ staunch refusal to do anything about this problem (with some honorable exceptions including county leaders and a few legislators like Rep. John Zerwas, who detailed his frustrations in this interview with the Observer that you should read), Texas will still get a great deal of benefit from the insurance exchanges. According to a report by the Society of Actuaries, Texas’ uninsured rate could drop from 27% to just under 15% if all eligible people take advantage of the exchange and the subsidies available to them; expanding Medicaid would have dropped that number to 10%, with the remainder basically being undocumented immigrants. This requires that people know about the exchanges and the subsidies, and fortunately there are various efforts underway to make that happen, since the state of Texas isn’t doing anything to help. If all goes reasonably well, many Texans could be a lot better off in another year.

Of course, there remain those who hope that nobody is any better off after the ACA kicks in.

Conservative analyst John Davidson of the free market-oriented Texas Public Policy Foundation said the liberal group – and writers of the federal law – ignore Census Bureau data showing that nearly 1 million of Texas’ 6 million uninsured residents make more than $75,000 a year.

“They have the means” to buy coverage, he said. “They don’t see the value in it.”

He said the Affordable Care Act’s success hinges on whether young, healthy adults will be prodded to buy coverage, which will “subsidize older, sicker people. Proponents of the law are going to be surprised how few young people are willing to take that deal,” Davidson said.

Yes, I’m sure that a privileged old guy like John Davidson knows exactly how people with whom he has nothing in common and for whom he has no empathy will behave. He’s just rooting for his preferred political outcome. Let’s see how good he is at making predictions after we get some data on this, shall we? Progress Texas, Health Zone, the Trib, and Kaiser Health News have more.

Medicaid expansion is now double secret illegal

Whatever.

It's constitutional - deal with it

It’s constitutional – deal with it

In a surprise turn in the House on Monday evening, a bill to reform Medicaid long-term and acute care services became a vehicle for the GOP’s platform against Medicaid expansion.

“Many of us are very weary of Medicaid expansion,” said state Rep. Jeff Leach, R-Plano, who offered an amendment to Senate Bill 7 that would ban Texas from expanding Medicaid eligibility without the approval of the Legislature. While House lawmakers recognize that Texas’ large number of uninsured residents is a problem, Leach said, “We don’t believe that Obamacare is the answer to that.”

Leach’s amendment — which was adopted with a vote of 87 to 57 — would prohibit the Health and Human Services Commission from providing “medical assistance to any person who would not have been eligible for that assistance and for whom federal matching funds were not available” under the state’s existing criteria for medical assistance.

State Rep. John Zerwas, R-Richmond, expressed concern that the “broad stroke” of Leach’s amendment would handicap the state’s ability to stretch federal matching dollars in other programs, such as the 1115 Medicaid waiver program.

“I’m the first to tell you that the Medicaid system is very fragile,” said Zerwas, who has pushed this session for the Legislature to weigh in on the Medicaid expansion debate by approving “a Texas alternative” based on private-market reforms. “But this particular provision, in terms of restricting any ability to utilize matching funds for the provision of health care, is not the right amendment for this bill,” he said.

But under current law, Leach said, the state health commissioner or governor could expand Medicaid coverage without legislative approval. The expansion of Medicaid eligibility is “too big of a decision for the future of this state to be made by one person, and I believe the Legislature ought to be involved,” he said.

It’s hard to say that this makes much difference. Barring the election of a Democratic Governor in 2014 – I’ll leave it to you to estimate the odds of that – it’s pretty much a moot point anyway. Since in adding this amendment SB7 was altered from the Senate version, it has to go to a conference committee, so the amendment could wind up getting stripped anyway. But in all honesty, it probably doesn’t matter anyway. BOR and Trail Blazers have more.

Maybe I buried Medicaid expansion too soon

I still think it’s dead, but I could be wrong about that.

It's constitutional - deal with it

It’s constitutional – deal with it

The fate of Medicaid reform in Texas could rest solely on an up-or-down vote on the 2014-15 budget.

State Rep. John Zerwas, R-Simonton, a member of the conference committee that is hashing out the differences between the House and Senate budget plans, said Monday he’s relatively confident that a rider stipulating the Legislature’s preferred Medicaid reform terms — like cost containment measures and private market reforms — for any deal with the federal government is “sticking” to the 2014-15 budget. The rider does not expand Medicaid, he clarified, and said he would be “happy to defend it” to his colleagues.

The 2014-15 budget is not yet finalized. Budget conferees are meeting Monday evening to discuss the health and human services section and could discuss the rider. It could also come up in future discussions on the proposed budget this week.

Republican lawmakers have made it clear that they won’t approve an expansion of Medicaid eligibility this session. And although some conservative GOP House members have vowed to reject the budget proposal if such a rider is included, Zerwas said the rider has the support of the majority of budget conferees. The budget does not include financing to expand Medicaid eligibility in the upcoming biennium.

“No amount may be expended to modify Medicaid eligibility unless the [Health and Human Services Commission] develops a plan to create more efficient health care coverage options for all existing and newly eligible populations,” states the budget rider, which was authored by Senate Finance Chairman Tommy Williams, R-The Woodlands.

The rider also says the Legislative Budget Board, which includes the lieutenant governor and House speaker, must ensure that any deal reached with the federal government to expand Medicaid eligibility cuts uncompensated care costs; promotes the use of private coverage and health savings accounts; establishes wellness incentives, cost-sharing initiatives and pay-for-performance initiatives; and reduces the state’s need to gain federal approval to make “minor changes” to the program.

(You can read the budget rider here, under contingent provisions in Article 9, Sec. 17.12. Certain Medicaid Funds.)

[…]

The Senate has approved the rider, but the House approved a nonbinding motion directing budget conferees not to include the rider on the budget.

State Rep. Van Taylor, a Tea Party favorite from Plano, told the Tribune on Tuesday that the conservative faction of the House was prepared to vote down the budget, if it called for an expansion of Medicaid.

“John wants it. I want it — so there’s two of us” who want to include the rider in the budget, House Appropriations Chairman Jim Pitts, R-Waxahachie, said on Tuesday.

I presume Sylvester Turner, who is also on the House conference committee, would be in favor of this as well. If so, then that should be enough support to include it. What happens after that is anyone’s guess. I’m sure Pitts is smart enough to not doom his own budget, but I don’t know how much faith I’d put in the Republicans; Democrats will have their own incentives, which may or may not line up with what Pitts wants. And if we are going to a special session as Burka is convinced we are, then I wouldn’t put it past Rick Perry to veto the budget out of spite. Let’s just say that the conference committee, which is meeting again and making some progress, is likely the lowest hurdle for this to clear.

Medicaid “expansion” likely dead

The calendar is a harsh mistress.

It's constitutional - deal with it

It’s constitutional – deal with it

The House’s lead health care budget writer says his bill to force Gov. Rick Perry’s administration to explore the potential for a “Texas solution” on Medicaid expansion is dead.

Rep. John Zerwas, R-Richmond, said Tuesday that his bill outlining an expansion of coverage for poor adults using private insurance, health savings accounts and cost sharing by the beneficiaries “got hung up in Calendars.”

He was referring to the House Calendars Committee, which is the traffic cop deciding which bills go to the House floor — and in what order.

“Wasn’t anybody there to rescue it,” Zerwas said of Calendars and his measure.

Although the Calendars Committee is expected to meet Tuesday, Zerwas said the only way his bill could avoid Thursday’s midnight deadline for passing House bills would be if it were placed on Thursday’s major state calendar. That would bump it ahead of scores of bills.

“I don’t think that’s in the cards at all,” said Zerwas, chairman of the Appropriations subcommittee on health and human services.

I can’t claim to be surprised. It just wasn’t a priority for the powers that be. The Trib notes that even though Zerwas bent over backwards to try to accommodate Rick Perry and the slash-and-burn crowd at the TPPF, they were still agin’ it, and that was enough to bottle it up. Yes, Calendars could still schedule it ahead of a bunch of other bills, which would endanger them all since HB3791 would surely take all day to debate, and yes it could get attached as an amendment to a so-called “Christmas tree” bill, but I wouldn’t count on either of those things happening, and even if they could they probably shouldn’t. Whatever you think about this – and to me, this bill barely rates a D minus – it deserved a real hearing, with everyone having the opportunity to amend it. It shouldn’t be tacked on to something else, and it shouldn’t get its time on the floor at the expense of everything else. Let’s start talking now about how our tax dollars will now go to help expand Medicaid in New York and California, and how we won’t even get that much money to enroll people in subsidized coverage through the exchanges in large part because Rick Perry didn’t give a crap about that, either. This was always about politics, so let’s make the failure to take action be about politics, too. Texas Politics has more.

Weekend legislative threefer

That sound you heard on Friday was Rick Perry stamping his feet if he doesn’t get his way.

Corndogs make bad news go down easier

I can eat these all summer if I have to

Gov. Rick Perry is warning state legislators that it could be a long, hot summer in Austin if they don’t pass his top priorities: funding water and transportation projects and cutting business taxes.

With a month left in the regular session, Perry spokeswoman Allison Castle said Friday that the governor is prepared to bring lawmakers back in special session if they don’t act on his signature issues.

“The governor laid out his priorities in January to ensure a strong economy for the next 50 years, including instituting fiscally sound budget principles, significant tax cuts and making sure Texas has the necessary roads and water infrastructure to support our growing state,” she said. “His priorities haven’t changed.”

Castle said the Legislature still has plenty of time to act before the clock runs out on the 83rd Texas Legislature next month. But she said Perry won’t stand for incomplete work on his top items.

“He’s been very clear that he won’t sign the budget until he signs significant tax relief,” she said. “And if they don’t address all of these priorities by the end of the session, the governor is willing to keep them here as long as it takes to get it done.”

Whatever. Perry is very likely to get the first two items on his wish list regardless of any threats. His ridiculous tax cut, I hope not. I note that story came out the same day as this one about legislative Republicans pushing back against Perry this session. Not a coincidence, I daresay, but we’ll see whether that attitude survives Perry’s meetup with the GOP caucus.

Meanwhile, the House approved a supplemental budget that included more money for public education.

Debate over a routine budget bill in the Texas House became unusually topical Friday as lawmakers touched on a fertilizer plant explosion in West, the murder of two Kaufman County prosecutors and the Travis County district attorney’s drunken driving arrest.

Lawmakers ultimately voted 129-9 in favor of House Bill 1025, which would add $874.9 million to the state’s current two-year budget. The bill includes $500 million more for public schools and more than $170 million in payments to state and local agencies to cover costs related to wildfires in 2011.

Lawmakers filed 20 amendments to the bill ahead of Friday. Nearly all of them were eventually withdrawn or rejected by the House. Members agreed to an amendment by state Rep. Kyle Kacal, R-College Station, that allows the governor’s office to “prioritize” the use of $2 million for recovery efforts after this month’s disaster in West. Kacal’s district includes the town of West.

One of the amendments that was subsequently withdrawn came from Rep. Phil King, who is trying to force Travis County DA Rosemary Lehmberg to resign. He attempted to use the process to move the Public Integrity Unit from Lehmberg’s office to that of the Attorney General, but did not succeed. I wouldn’t put it past him to try again later, however. In any event, the best thing to come out of this debate was the wailing and gnashing of teeth by the slash-and-burn crowd.

Finally, the Texas Association of Business has endorsed the Zerwas plan for Medicaid “expansion”.

“If we can take the money on our terms and conditions then it is something we ought to do,” said Bill Hammond, president of the group, whose board voted in January to oppose expanding Medicaid as called for under the federal Affordable Care Act. The basis of Zerwas’ plan is to negotiate a deal that allows the state to use federal Medicaid expansion dollars to subsidize private coverage, which Hammond said is a workable solution. “We encourage them to march to Washington to try to cut a deal,” he said.

House Bill 3791, authored by Zerwas, R-Simonton, has four parts: It outlines what the state’s request for a federal block grant to reform the current Medicaid program could look like; identifies Medicaid reforms that Texas could implement already, such as cost-sharing requirements and co-payments; sets up a separate program to potentially draw down federal financing to help individuals at or below 133 percent of the poverty level find private market coverage; and sets up an oversight committee for both programs.

“This is not an expansion of Medicaid — this is the creation of a new program that leverages our private sector,” Zerwas told the House Appropriations Committee, which voted 15 to 9 on Tuesday to move the legislation out of committee and continue debate on the House floor.

Like I said, I’m lukewarm on the idea, but it is the best we could get at this time. Lord, we need a new government in this state.

Medicaid “expansion” bill passes out of House committee

Forgive me for tempering my excitement about this, but it’s not that much to be excited about.

It's constitutional - deal with it

It’s constitutional – deal with it

Despite opposition from conservative Republicans, the House Appropriations Committee on Tuesday advanced a proposal that would reform Medicaid by allowing the state to request a block grant from the federal government and expand coverage to low-income Texans.

“This is not an expansion of Medicaid — this is the creation of a new program that leverages our private sector,” said Rep. John Zerwas, R-Simonton, the author of House Bill 3791. Members of Appropriations voted 15 to 9 to move the legislation out of committee and continue debate on the House floor.

[…]

The revised bill has four parts: It outlines what the block grant would look like; identifies Medicaid reforms that Texas could implement already, such as cost-sharing requirements and co-payments; sets up a separate program to potentially draw down federal financing to help individuals at or below 133 percent of the poverty level find private market coverage; and sets up an oversight committee for both programs.

Trail Blazers fills in some details.

[HB 3791] would, among other things, attempt to appease hospital leaders and urban county judges and commissioners who are irate over state GOP leaders’ apparent determination to walk away from about $100 billion in additional federal funds that Texas could draw down over the next decade. The money would flow to Texas if it expands Medicaid to more adults — a move that would pull forward to government coverage more than 400,000 poor children who are already eligible but haven’t enrolled. Texas would have to put up just more than $15 billion of its money through 2023.

[…]

The bill by Zerwas, though, would at least force Team Perry to go through the motions [of negotiating with the Obama administration]. Governors in other states have reached some deals with federal Medicaid czars, some involving private insurance subsidies as an alternative to traditional Medicaid.

Zerwas’ measure says any Texas-specific premium assistance plan must include features near and dear to conservative lawmakers’ hearts. The deal must include outcomes-based provider reimbursements, “meaningful cost sharing requirements and wellness initiatives,” tailored benefits, nudges for existing Medicaid recipients to take the premium subsidies and for people to accept employer-offered coverage — and of course, health savings accounts, which allow patients to spend from a pool of dollars that rolls over at the end of the year and they keep.

“I understand the kind of political radioactivity around this particular bill,” Zerwas told colleagues. “But I … am hearing and many of us are hearing especially from our county and local governments that this would have a profound effect not only on the provision of care [but] some of the collateral effects are its potential to reduce property tax rates” charged by county hospital districts, such as one in Dallas County that supports Parkland Memorial Hospital, he said.

Rep. Stefani Carter, R-Dallas, praised Zerwas’ hard work but said she had to vote no because his bill needs more vetting. Carter questioned how many of her constituents would benefit.

Democrats weren’t thrilled by the laundry list of conservative “health care reforms” in the bill but went along.

“Cautiously, yes,” said Rep. Helen Giddings, D-Dallas, announcing her vote.

What Rep. Giddings says. As with the Arkansas option, this is a Rube Goldberg monster whose complexity is a direct result of Republican intransigence to the obvious solution. It’s a kluge on top of a kluge that starts out by wishing for a pony – block grants – then resigns itself to coming up with something that won’t require the state to give up on billions in funding. It’s still better than nothing, which once again gives you an idea of how awful the status quo is. Better Texas has more.

On a side note, the House also instructed conference committee members to not expand Medicaid in the budget reconciliation negotiations. Which they couldn’t do anyway, since you can’t use the budget to make new law, but never mind that. The Republicans in the Legislature are wise to Barack Obama and his sneaky tricks, yes they are. Whatever happens from this point, it needs to happen quickly because time is running short in the session. The issue could be picked up again in a special session, but only if Rick Perry wants that to happen. Getting it done now is the best bet by far.

What Obamacare will do for Texas

Even without Medicaid expansion, the Affordable Care Act will help millions of Texans get access to health care.

It’s constitutional – deal with it

Nearly 2.6 million Texans could qualify for tax credits to purchase health insurance in 2014, according to a report released Thursday by Families USA, a nonprofit that advocates for health care consumers.

The tax credits will be offered through the health insurance exchange — an Orbitz-style online marketplace for health insurance — that the federal government plans to launch as part of the Affordable Care Act in October. Beginning in January, families with an income of up to 400 percent of the federal poverty line, between $47,100 and $94,200 for a family of four, will be eligible for a tax credit subsidy to purchase insurance through the exchange. The tax credits will be offered on a sliding scale, so that lower-income families will receive larger credits.

“These are typically the families where folks are working, sometimes more than one job,” U.S. Rep. Pete Gallego, D-Alpine, said of the report. “Regardless of where you are on the political spectrum, I think that’s something we can all support.”

Nearly 5.8 million Texans — nearly a quarter of the state’s population — are uninsured. The Health and Human Services commission estimates the tax credits offered through the health insurance exchange and other provisions in the Affordable Care Act will lower that rate to 16 percent. If Texas also expanded Medicaid — an unlikely scenario given Gov. Rick Perry’s opposition — the uninsured rate could be lowered to 12 percent.

“Given the large number of people in Texas that are uninsured, many of whom are poor, this is an extraordinary opportunity,” said Ron Pollock, executive director of Families USA. He said it was “short-sighted” for the state’s leadership to oppose Medicaid expansion, as it would bring billions of federal dollars to the state, and increase job opportunities.

You can see the report for Texas here, and for other states here. That still leaves about a million people who would be able to get Medicaid if the state agrees to expand it, but we know how little Rick Perry cares about these people. Trail Blazers has more on the Families USA report.

Elsewhere on the Medicaid front, HHSC Commissioner Kyle Janek has been given the go-ahead to negotiate with the U.S. Centers for Medicare & Medicaid Services. At the time, he wasn’t given any direction about what to negotiate for or toward, but perhaps now that the Zerwas bill has been discussed in committee there’s something tangible for him to talk about. We’re unlikely to hear much about his effort and any progress he may make since apparently talking about it in public spooks people, the way saying the name “Voldemort” does in the Harry Potter books. Lord only knows what might happen, but hey, at least they’re talking. EoW has more.

House discusses Medicaid expansion

Sounds like a sincere effort, though whether it can get anywhere is an open question.

It's constitutional - deal with it

It’s constitutional – deal with it

Amid hours of testimony from advocates in support of Medicaid expansion on Tuesday, state Rep. John Zerwas, R-Simonton, described his proposal to create an alternative program that could draw down federal financing to provide health coverage for poor and uninsured Texans.

“I think it’s incredibly important that we do something that can be discussed and debated on the floor of the House,” Zerwas said before outlining House Bill 3791 during a meeting of the House Appropriations Subcommittee on Budget Transparency and Reform. “I think the citizens of Texas expect us to have that conversation.”

“The bill is intended to not be an expansion of Medicaid,” he added.

HB 3791 would require the state’s health commissioner to craft a “Texas solution” to health care expansion by pursuing a waiver or authorization from the federal government to reform Medicaid while expanding coverage to poor adults. Under Zerwas’ proposal, the waiver must be cost-neutral and allow Texas to leverage tax revenue collected from premiums on health care plans to pay for the state’s portion of the program’s costs. It must also allow the state to save money by tailoring Medicaid recipients’ benefits, implementing “personal responsibility” cost-sharing measures, such as co-pays and deductibles, and prioritizing premium assistance for private market health plans.

If negotiations with the federal government were to fail, the bill would require Texas to set up the same program with state funds.

“This is intended to try to promote personal responsibility,” said Zerwas, explaining that the program would support many options for poor individuals to find health coverage through the private market. “It’s not a one-size-fits-all.”

The bill was left pending in committee.

State Rep. Garnet Coleman, D-Houston, a joint author on Zerwas’ bill, said it would allow the Legislature to weigh in on the best way to cover the poor and uninsured.

“Let’s take what we want up there and let’s advocate for what the majority of the people in this Legislature think,” he said. As an example, he said, the bill would allow the state to help people who want one to obtain a health savings account.

If Rep. Coleman is involved then you can be reassured the bill will be meritorious, if not ideal. At least it’s intended to be expansionary, unlike some other proposals that have been floated. But it’s still not the best we could do.

“This is not Medicaid expansion; this is Texas Plus or Medicaid Plus One,” said state Rep. Sylvester Turner, D-Houston, who laid out his House Bill 3376 at the House Appropriations Subcommittee on budget transparency and reform.

HB 3376 would expand Medicaid coverage to individuals below 133 percent of the federal poverty line. The bill includes a severance clause that requires the state to stop financing the program if the federal government reduces its share of financing below 90 percent and — “in the spirit of conservatism,” as Turner put it — also includes cost-sharing requirements such as co-payments.

“I don’t think anyone can dispute the numbers. We may dispute whether or not we want to do it,” said Turner, emphasizing that the state comptroller estimates expanding Medicaid coverage as proposed in HB 3376 would save the state $50.4 million in the 2014-15 biennium. “From a fiscal, financial, budgetary point of view, the numbers are overwhelming.”

Unfortunately, so are the odds against Rep. Turner’s bill passing. What’s best is not always politically doable, and though the opposition has no good argument, they have the numbers. What are you going to do? Let’s support Rep. Zerwas’ bill and hope for the best. Texas Well and Healthy has more.

Williams’ “Medicaid” plan

I’m really not sure what to make of this.

It’s constitutional – deal with it

State Sen. Tommy Williams, R-The Woodlands, is crafting a Medicaid reform plan that would use premium tax revenue to subsidize private health plans for uninsured Texans, his office confirmed on Tuesday night.

Gary Scharrer, a spokesman for Williams, said the proposal is “still a concept,” one that is designed to “buy some time” as Texas debates how to overhaul Medicaid in the midst of pressure from the federal government to embrace elements of the Affordable Care Act, or “Obamacare.”

According to early details, Williams’ plan would scrape premium tax revenue from newly insured Texans who sign up for coverage under the state’s health insurance exchange — an online insurance marketplace that is mandatory under federal health reform — and use it to subsidize private coverage for poor, uninsured Texans starting in late 2015.

Scharrer cautioned that Williams’ proposal does not call for expanding Medicaid, which the state’s top Republican leaders adamantly oppose. Nor does it call for raising taxes; the premium tax revenue will be a side effect of more Texans being forced to buy insurance under the Affordable Care Act.

Williams is “really emphatic that Texas will not extend or expand the current Medicaid system,” Scharrer said.

I can’t tell what the goal of this is. Is it to help provide health care coverage to people who otherwise wouldn’t have it? In particular, is it intended as a way to provide some kind of health care coverage to people who would be eligible for Medicaid if Texas would agree to expand it? The Express News suggests that this is indeed the case.

Williams said the money from the extra premium taxes could be used to pay for Texas’ cost of expanding health care coverage to those who would otherwise qualify for Medicaid expansion.

His preference would be to add them to the insurance exchange and help them to buy coverage, although he said it also could be done by putting them in a revised Medicaid program.

He would like to wait until September 2015. That would give lawmakers another regular legislative session in 2015 to examine the program.

“And so I don’t want us to get committed to any program that we can’t pay for and that the federal government is not going to pay for,” Williams said.

Of course, the federal government is paying for it, assuming that Williams’ Republican colleagues in Washington don’t succeed in figuring out some way to cripple it. One must admit there is some risk to that, however perverse the whole thing is. Be that as it may, I’d like to know how much revenue Williams thinks he can “scrape” this way, and how many people it would help. I’m going to step out on a limb and guess that the number is smaller than the number of people who would be eligible for expanded Medicaid. More importantly, why this for a revenue source and not the billions of dollars of federal money available? Back to the Trib for that:

State Rep. John Zerwas, R-Simonton, confirmed Wednesday that he will incorporate into his own Medicaid reform bill a proposal by Sen. Tommy Williams, R-The Woodlands, to use premium tax revenue to subsidize private health policies for the uninsured.

“It fits very well with Texas’ attempt to find a unique solution that would be sustainable,” Zerwas said. He said the measure would allow Texas to embrace some parts of federal health reform “earlier versus later,” and would “hopefully bring insurance policies to these people that otherwise wouldn’t have them.”

But the two lawmakers diverge on a key point — whether or not to draw down billions of federal dollars to expand the state’s Medicaid-eligible population under the Affordable Care Act.

[…]

Medicaid expansion is “completely off the table — what I’m interested in is a reform program,” Williams said Wednesday morning.

Zerwas said he authored House Bill 3791 to craft a “Texas solution” to Medicaid reform that would allow the state to draw down federal Medicaid expansion financing while implementing cost containment reforms. So far, Zerwas has suggested those reforms include co-payments and wellness incentives, but the details of his plan remain thin.

Still not clear what, other than straight up antipathy to Medicaid and the ACA, is driving Williams’ refusal to draw down federal funds. The sad thing is that even this baby step, two years out, would be a big improvement over anything the Republicans have done to health care in Texas. It’s ridiculously limited and needlessly complicated, which gives you some idea of just how bad the status quo is, but it’s still a tiny nudge forward. I just hope Rep. Zerwas’ perspective wins out in the end.