Advocating for sound healthcare public policy

Texas Health is committed to helping the most vulnerable in our community access safe, affordable, and quality healthcare while ensuring its caregivers have the tools, protections and training they need. From bolstering the healthcare workforce to enhancing behavioral and maternal health services, Texas Health advocates for public policies that enable the organization to stabilize, strengthen and sustain its Mission of improving the health of the people in the communities we serve.

Texas Health champions bipartisan and collaborative solutions that align with its federal and state public policy priorities through direct engagement and meetings with policymakers, hospital site visits, stakeholder events and other forums.

2023 Highlights

Texas Health’s Government Affairs and Advocacy team navigated a very contentious and challenging public policy environment. Special interest groups and certain lawmakers promoted legislation that would be detrimental to patient care, severely hamper access to care and hurt hospitals’ bottom lines. They also promoted unfair, biased, and misinformed attacks on hospitals and health systems, inaccurately portraying them as the primary driver of rising healthcare costs. This false narrative fails to adequately account for uncompensated care and underpayment from government healthcare programs, as well as the rising costs for staff, technology, equipment and the complex regulatory compliance necessary to provide safe, quality care 24/7/365.

Despite these challenges, we engaged lawmakers to create and support public policies that would enable Texas Health to:

Expand, sustain and protect its workforce

Texas legislators approved funding to help the state recruit and retain critical healthcare professionals over the biennium. These include:

  • $233 million to maintain the state’s desired ratio of residency slots to medical school graduates. Research shows that students who complete their residency in Texas are more likely to remain here.
  • $16.5 million in grants for family practice and $3 million for rural physician residency programs.
  • Loan repayments in exchange for clinicians working in areas with staffing shortages. Legislators allotted $35.5 million for physician loans, $28 million for mental health professionals and $7 million for nurses.
  • $47 million in nursing school budget allocations for faculty, clinicals and preceptorships and $25 million for nursing scholarships.

Additionally, Texas Health advocated for legislation to help prevent and address workplace violence against healthcare workers, which passed at the state level. These measures are critical to protecting, attracting, and retaining valuable caregivers and employees.

Maintain financial stability

The state of Texas has the highest rate of uninsured people and removed more than 2 million people from Medicaid since federal pandemic-era coverage protections were lifted. Hospitals are required to provide emergency treatment to anyone in need but are not fully compensated for the actual cost of care delivered.

Medicare, which insures adults aged 65 and above, currently reimburses hospitals only 82 cents on the dollar for the cost of services. Medicaid, which extends coverage to low-income children, pregnant women, individuals with disabilities and elderly individuals in long-term care, reimburses hospitals 72 cents for $1 of inpatient care and 75 cents for $1 of outpatient care.

We advocate for lawmakers to close these and other funding gaps to sustain Texas Health’s ability to deliver quality care to people in need. During the year, Texas Health successfully lobbied to:

  • Prevent $16 billion in cuts to Medicaid disproportionate share hospital (DSH) payments from taking effect.
  • Block site-neutral payment cuts that would have reduced access to critical healthcare services in rural and underserved communities.
  • Protect the 340B drug savings program, which gives under-resourced communities access to more affordable drug therapies. The U.S. Department of Health and Human Services will fully reimburse 340B hospitals for payments withheld from 2018 to 2022.
  • Maintain hospitals’ Medicaid reimbursement rates, including payments for safety net hospitals, rural hospitals, and trauma care.
  • Create a Local Provider Participation Fund (LPPF) in Collin County (as well as extend existing LPPFs in Dallas and Tarrant counties) that enables hospitals in these counties to collaborate with local government entities (i.e., hospital districts and counties) to collect mandatory payments from hospitals. These payments are matched by federal funds and redistributed by the state Medicaid agency to compensate hospitals for delivering services to Medicaid and uninsured patients.

Enhance behavioral and women's health

Texas Health successfully received policymaker approval to:

  • Extend postpartum Medicaid coverage for new mothers in Texas from two months to 12 months.
  • Require the Texas Judicial System to develop a process for expediting a healthcare facility’s ability to detain a person experiencing a mental health crisis for their safety as well as the safety of others.
  • Allocate more than $100 million to construct a state psychiatric hospital in Dallas, the state's largest urban area without such a critical facility.

Protect consumer access to care and coverage

Texas Health also received policymaker approval to:

  • Modernize telemedicine and broadband capacities in rural and underserved areas to expand access to care.
  • Clarify ethical and communication requirements for end-of-life care, making advanced directives more seamless.
  • Hold payers accountable for selling insurance products that adequately meet the needs of their enrollees when they need them most.
  • Continue a federal hospital-at-home program, which helped hospitals manage COVID-19 surge capacity by treating eligible patients at home.

Additionally, Dallas was selected as an innovation hub for the U.S. Department of Health and Human Services' Advanced Research Projects Agency for Health. The program will accelerate the development of scientific breakthroughs for diseases such as Alzheimer’s, diabetes, and cancer, create new high-skilled jobs in the region and facilitate economic growth.

Snapshot: Advocating for Workplace Safety

In response to escalating intimidation and violence against healthcare workers, Texas Health's Government Affairs and Advocacy team collaborated with state lawmakers to pass legislation that strengthens workplace protections and promotes a safer environment. They:

  • Require hospitals to implement a workplace violence prevention policy, establish and maintain a workplace violence prevention committee, and deliver workplace violence prevention training at least annually. Retaliation or discipline for reporting a violent incident in good faith is prohibited. Texas Health already had these important measures in place.
  • Increase the penalty for assaulting hospital personnel to a third-degree felony on hospital property.
  • Direct employers to post information on how employees can report workplace violence or suspicious activity to the Texas Department of Public Safety.

At the federal level, Texas Health continues to advocate for the passage of the Safety from Violence for Healthcare Employees (SAVE) Act, which would give healthcare workers the same protections against assault and intimidation that flight crews and airport workers have under federal law. We hope these measures will restore safe work environments and allow healthcare facilities to be places of refuge and healing.