Tha who we are
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THA – Who We Are. The Texas Hospital Association is a nonprofit trade association representing Texas hospitals and health systems.

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THA – Who We Are

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THA – Who We Are

  • The Texas Hospital Association is a nonprofit trade association representing Texas hospitals and health systems.

  • In addition to providing a unified voice for health care, THA serves its 500+ members with advocacy, timely information, data analysis, education on essential operational requirements, networking and leadership opportunities.


Top Three Concerns - Tom Green County*

  • Health Issue-

  • Not having enough money to pay the doctor, buy Rx drugs, or get medical insurance (most serious)

  • Health Issue-

  • Prevalence of anxiety, stress and depression

  • Economic Issue-

  • Unemployment, finding it difficult to budget

  • * Concerns identified by 2,015 households in the 2004 Comprehensive Needs Assessment of Tom Green County


Why Health Care Matters to Everyone

  • A health care system brings employers and professionals to community

  • Hospitals are one of biggest employers in each community

  • Responsibility of providing health care to uninsured increases costs to everyone

  • $1551 of you health insurance premium is paid to cover the cost of care for uninsured

  • Cutting health care funding ≠ less sickness… only shifts burdens to local governments, hospitals and people of Texas


Access to Health Care Matters Here

  • 50% of households served by hospitals report an avg. income of $35K/yr=working poor

  • 50% of these households have a high school diploma or less

  • Major community health issues:

  • -Lack of affordable medical care

  • -Alcohol and/or drug abuse

  • -Teen pregnancy

  • -Lack of adequate medical care or lack of MDs

  • -HIV/AIDS

  • -Mental illness or emotional illness

  • *2004 Comprehensive Needs Assessment for Tom Green County


Economic Losses from Cuts to Texas’ Medicaid Program and CHIP*

  • For every $1 cut in state funding for CHIP and Medicaid:

  • $2.32 in lost Federal health care funding

  • $6.92 in gross state product losses

  • $1.59 in increased insurance premiums

  • $0.58 in local government cost increases and revenue losses

    * The Perryman Group, February 2005, THA commissioned report


Local Economic Losses from Cuts to Texas’ Medicaid Program and CHIP*

  • State of Texas-Health Services Alone ($ 1.5B)

  • County Total Expenditures Losses

  • -Tom Green ($ 32,500,000)

  • -Coke ($1,000,000)

  • -Concho ($810,617)

  • -Irion ($ 388,863)

  • -Runnels ($3,400,000)

  • -Sterling ($ 274,941)

  • Planning Region-Concho Valley-($44,400,000)

  • * The Perryman Group, February 2005, THA commissioned report –Total expenditure loss figures include Gross Product, Personal Income and Retail Sales categories


The Crisis Is Real - Putting It in Perspective

  • Texas leads the nation in the percent of uninsured residents—Nearly one in four=about 5.6M lives

  • The number of uninsured Texans could fill the UT football stadium more than 70 times

  • There are more Texans without health insurance than the entire population of the DFW metroplex

  • 79% of the uninsured work or have a working family member—however, insurance is either not available or unaffordable


The Challenge of the Uninsured in Texas*

  • Over 50% of the uninsured are poor—incomes at or below $41,300 for family of 4

  • Roughly 75% of the uninsured are US citizens

  • Almost 60% of the uninsured are under age 34

  • Small businesses = 72% of all private employers, but only 24% offer insurance--citing affordability and complexity of the market as barriers

  • More than 75% of part-time employees in Texas work in jobs that offer insurance, but only 23% of these workers qualify for coverage

  • *Texas Dept. of Insurance Data on Uninsured Texans


The Challenge of the Uninsured in Texas

More Uninsured Texans = Higher $ Premiums =

More Uninsured Texans = Higher $ Premiums =

More Uninsured Texans = Higher $ Premiums =

More Uninsured Texans = Higher $ Premiums ∞


80th Legislative Session

  • THA’s #1 Priority

  • Increasing Access to Affordable Health Insurance and Health Care


Legislative Solutions to Discuss

  • Interim work to educate; develop reform principles

  • Thinking “Outside the Box” on Solutions for the Uninsured

  • Medicaid Reform and Provider Payment Restorations

  • Access for Children to Healthcare

  • Workforce Shortages Addressed

  • Transparency of Health Care Costs


80th Legislative Session Atmosphere

  • No $10B shortfall or school finance reform as in past

  • The bolo tie proclaimed the Official State Tie

  • Athens officially named the origin of the cheeseburger

  • Speakers Race and then House attempted to move to vacate the chair of the Speaker

  • Senate gets Feisty

  • Conflict with fiscal conservatives and the reality of Texas’ expanding health care demographics


Hospitals Think “Outside the Box” for Solutions

  • Regional or statewide premium assistance programs for small employers --$ 1M Budget impact

    (SB 922 moved to SB 10)

  • Require companies receiving Texas Enterprise Fund to provide insurance to employees -$0 Budget impact

    (SB 1023-died)

  • In awarding government contracts, give preference to companies that provide insurance -$0 Budget impact

    (HB 1182-died)

  • Allow parents to carry coverage for children on their policy without regard to age -$ Budget impact undetermined

    (HB 3361-died)

  • Health Care Coverage for Texas Omnibus Bill -$3.2B Budget impact

    (HB 2863-died)


Reform Medicaid - Possible Solution

  • Medicaid Reform – SB 10

  • Authorizes THHSC to develop “multi-share” models for premium assistance

  • Allows establishment Health Opportunity Pool to preserve federal dollars for uncompensated care (Medicaid Dispro Dollars and Upper Payment Limit Funds)

  • Requires THHSC to standardize reporting of uncompensated care in hospitals

  • Creates Legislative Oversight Committee

  • Creates Committee on Health and Long-Term Care Insurance Incentives

  • $17M Budget impact


A Real Solution – CHIP, CHIP Hooray vs. CHIP Away!

  • CHIP Restorations – HB 109

  • 127,000 children added to program

  • 12-month continuous eligibility w/ 6-month income check for >185% FPL

  • Deduction for child care expenses

  • Modification of asset test

  • Removed 90-day waiting period for most cases

  • $69.2 M Budget impact--but $2 from feds for every Texas $1 spent


A Real Solution – Addressing Nursing Shortage

  • Nursing Shortage in Texas is critical:

  • By 2010 Texas will be short 27,000 nurses

  • Texas hospitals average 11% RN vacancy rate

  • Average age of nurse is 46, nurse faculty is 54

  • 11,000 qualified students turned away from nursing schools in 2006

  • SB 992 and HB 1—almost $20 million to address faculty shortage

  • SB 993—improve the workplace for nurses so they will stay in the profession

    We must recruit AND retain nurses!


A Real Solution – Addressing Physician Shortage

  • Graduate Medical Education (GME) Funding

  • Battle of the Budgets—Higher Ed vs. HHSC

  • No funding for GME in the Medicaid budget

  • Residency slots in Texas lower than other states—

    TX-5900, CA-9500, NY-14000

  • 45% of Texas medical students go to residency slots out of state

    Code Red Report Recommendations:

  • ⇑ the number of annually graduating MDs from Texas medical schools by 20% over the next decade

  • State support of residency programs should ⇑ slots by 600/biennium for the next decade


Transparency of Health Care Costs to Consumer – A Real Solution

  • SB 1731 by Senator Duncan:

  • Expands consumer access to health care information – TDSHS and TMB

  • TMA, TAB, TAHP, TASCS collaboration

  • Information on facility and physician pricing practices

  • Addresses balance-billing by facility-based physicians

  • Health plans required to report provider reimbursement rates to TDI for aggregate reporting to public

  • Website for Texas Hospital Inpatient charges- http://www.txpricepoint.org


So, What’s Next???

  • The 81st Legislative Session is 16 months away!!


THA will continue to:

  • Work with the SB 10 committee to study ways to reduce uninsured

  • Make health care an issue in upcoming elections

  • Educate business community that funding Medicaid and CHIP is a good thing

  • Support and promote legislation that expands health care coverage

  • Support and promote legislation that funds the state’s health care workforce


Words to Ponder

  • “To preserve health is a moral and religious duty, for health is the basis of all social virtues. We can no longer be useful when we are not well.”

  • Samuel Johnson, English Poet/Writer


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