th Legislature and Policy Planning for the 86 th th Congress Depends - - PowerPoint PPT Presentation

▶
th legislature and
SMART_READER_LITE
LIVE PREVIEW

th Legislature and Policy Planning for the 86 th th Congress Depends - - PowerPoint PPT Presentation

Jul 30, 2023 208 likes •391 views

th Legislature and Policy Planning for the 86 th th Congress Depends on Who Wins 116 th 116 Presentation to Healthcare Financial Management Association November 16, 2018 Rosie Valadez McStay, MPH Assistant Vice President, Government

slide-1
SLIDE 1

“Policy Planning for the 86th

th Legislature and

116 116th

th Congress Depends on Who Wins”

Rosie Valadez McStay, MPH Assistant Vice President, Government Relations and Community Benefits Texas Children’s Hospital Frederic C. (Freddy) Warner Jr., JD Chief Government Relations Officer Memorial Hermann Health System

Presentation to Healthcare Financial Management Association November 16, 2018

slide-2
SLIDE 2

Presentation Overview

  • Civics 101 Quiz
  • Election Outcomes and Insights from the results
  • State and Federal Policy Considerations
  • Questions/Discussion
slide-3
SLIDE 3

Civ ivics 101 – How well do you know government?

  • How many members are elected to the US

House of Representatives each election cycle?

  • 435
  • How many members are elected to the US

Senate each election cycle?

  • About a third
  • How many members are elected to the Texas

House of Representatives?

  • 150
  • How many members are elected to the Texas

Senate?

  • 31
slide-4
SLIDE 4

Civ ivics 101 – How well do you know government budgets?

  • What is the total FY 2018 budget for the

Federal Government?

  • $4.4 Trillion
  • What was the revenue received by the

Department of the Treasury?

  • $3.316 Trillion
  • What is the biennial FY ‘17-’18 budget for

the State of Texas?

  • $216.8 B
  • How much net revenue did Texas receive
  • ver the biennium?
  • $111.2 B/year
slide-5
SLIDE 5

Ele lection outcomes in in the US Congress

Photo Credits – CNN.com

slide-6
SLIDE 6

Ele lection outcomes in in the US Senate

Photo Credits – CNN.com

slide-7
SLIDE 7

Take-Aways fr from DC

Women Serving in the 115th vs. 116th Congress House and Senate Chamber Flips since 1930

slide-8
SLIDE 8

Other Election Take-Aways

Texas Election Demographic Drivers National Demographic Trends

Governor Election Results

slide-9
SLIDE 9

Ele lection Outcomes - Texas House

Current Make-Up

  • Republicans:

83 Seats

  • Democrats

67 Seats

  • Speaker:
  • Rep. Dennis Bonnen
slide-10
SLIDE 10

Ele lection Outcomes - Texas Senate

Current Make-Up

  • Republicans:

19 Seats

  • Democrats

12 Seats

  • Senate President: Lt. Gov. Dan Patrick
slide-11
SLIDE 11

Texas County Ele lections

Election Results by Texas County Harris County Judge-Elect Lina Hidalgo

Photo Credit – CNN.com Photo Credit – Linahildalgo.com

slide-12
SLIDE 12

12

State Budget Overv rview

Photo Credit: Texas Comptroller’s Office

slide-13
SLIDE 13

Some additional facts to consider…

Texas Uninsured Rate (age 18-64, [2015]) Current Medicaid Expansion States

Photo Credit: Texas Academy of Family Physicians (TAFP); U.S. Census Bureau. (2015, March)

slide-14
SLIDE 14

Health Systems in Texas legislative priorities will focus on fiscal impacts of policies:

  • Maintenance of safety net, trauma and rural add-ons from 2015 and 2017 sessions
  • Despite 2015 and 2017 “add-ons,” rate is only 58% of cost of care
  • Senate and House included in 2017 base budgets
  • Preservation of the state Trauma Fund
  • Local Provider Participation Funds (LPPF) proposals
  • Continuation of 1115 Medicaid Waiver
  • CMS granted initial 5-year term in 2011, followed by 15-month extension, which

ended 12/31/17

  • In December 2017, CMS renewed the waiver for another 5 years, through 2022
  • Yields $6 billion per year
  • Texas could receive $8.5 billion/year in federal Medicaid expansion funding
  • HHSC/CMS negotiating terms and conditions, rulemaking, continue

State Policy Priorities for Health Systems

slide-15
SLIDE 15

1115 Medicaid Waiver – Largest Supplemental Funding Strategy

December 2017, CMS approved a new, 5-year, $25 Billion Medicaid waiver

  • Maintains existing funding levels for Uncompensated Care (UC) and Delivery System

Reform Incentive Payment (DSRIP) program

  • Winds down funding for DSRIP projects to zero, between years 3 and 5;
  • Mandates transition from the current “UC tool” to S-10 worksheet
  • Medicaid shortfall no longer allowed
  • Bad debt costs no longer allowed

General waiver renewal terms enumerate timelines for implementation of changes to funding methodologies, and penalties for failing to achieve milestones

slide-16
SLIDE 16
  • Lame Duck session (now thru end of the year)
  • ACE Kids Act
  • Impact of a split Congress –Math of election voters is on Democrats’ side
  • Impact on the Affordable Care Act (ACA)
  • Election cycle created opportunities for several states to consider

Medicaid expansion

  • Congressional Democrats will shore up the ACA; Republican AG lawsuit

might weaken it

  • Drug Pricing Reform
  • Price Transparency and Consumer Protections
  • 340 B Discount Drug Program
  • Stark Law Reform

116th Congress – Health Sector Impacts

slide-17
SLIDE 17

In summary…

Will the 86th Legislature be a microcosm of 116th Congress?

  • New Speakers in both the state and federal Houses – and both

march to their own drummer – not going to follow their Senate counterparts

  • Many spending needs – Education, Infrastructure,

Transportation, Health care (e.g. Mental Health and Veterans Care), etc.

  • How these needs are prioritized largely depends on leadership.
  • Will partisanship continue to thrive or will pragmatism win?
slide-18
SLIDE 18

Thank you!

Rosie Valadez McStay, MPH Assistant Vice President, Government Relations and Community Benefits Texas Children’s Hospital Lrmcstay@texaschildrens.org @TXChildrensGR Frederic C. (Freddy) Warner Jr., JD Chief Government Relations Officer Memorial Hermann Health System Frederic.Warner@memorialhermann.org