BY John Hawkins
At Austin’s most well-known building, plenty of important work happens when most of Texas isn’t paying much attention.
In even-numbered years, when the Texas Legislature isn’t in session, our state lawmakers still have plenty to do at the Capitol – and so does the Texas Hospital Association. That’s when legislative committees study specific topics – known as interim charges – that lay the groundwork for what’s to come when the Legislature reconvenes the following year.
At this writing, we don’t yet know what those interim charges – issued by the speaker of the House for that chamber, and the lieutenant governor for the Senate – will look like. But we know what we would like lawmakers to look at, and we’ve shared our thoughts with key legislators on what hospital and health care issues particularly need their attention before the 90th Legislature gavels in next year.
For starters, it’s imperative that the Legislature take a hard look at health care costs. Of course, there are many different dimensions to this burning topic as it applies to hospitals. We hope lawmakers will scrutinize the cost benefits that can be realized from reducing mandates on hospitals and physicians and also look at how eliminating mandates on insurers has affected both patients and our providers. We also would like to see detailed study on costs in the health care workforce – the biggest driver of spending that our hospitals face – and on other key aspects such as drug costs, administrative costs and underpayments from both private and government insurers.
Mental health continues to be a major focus in our policy pursuits at THA, and it needs to be in state lawmakers’ sights this year as well. Specifically, among other aspects of the issue, we’d like to some examination of the inter-relationships among all the entities that make up our behavioral health landscape and respond to crisis events – including general hospitals, psychiatric hospitals, law enforcement, schools and the judicial system. It’s also important for lawmakers to identify reasons why patients exit their mental health programs before completing them, as well as the administrative or financial reasons why mental health facilities operate at limited bed capacity.
As always, prior authorization burdens continue to be a bear for health care providers all over Texas. Misuse and overuse of these tactics by insurers continues to be all too prevalent – in fact, insurance and billing account for more than 80% of administrative expenses in health care. Reducing this burden – and realizing an accompanying drop in the overall cost of delivering care – needs to be a goal.
On the public health front, we’re coming off a year that saw Texas host both a major measles outbreak in the west and catastrophic flooding in the central part of the state. Those events highlighted our need to particularly address state funding in rural and underserved areas. We hope legislators will conduct a thorough review of our state’s emergency response to potentially devastating events like vaccine-preventable disease outbreaks, natural disasters and other mass casualty events.
These issues – and many more that we highlighted in our interim recommendations to lawmakers – are vital to building a healthy future for Texas. Don’t check out on the interim – even though laws don’t get passed, the seeds of 2027 are planted in its soil. Stay engaged and help Texas health care emerge from that soil with strong branches and vibrant leaves that paint a bright future for healthy Texans.