Lege Wrap-Up

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Workers' Comp: Disagreeing to Agree

It took Gov. Rick Perry to broker a last-minute agreement on workers' compensation, after the two chambers deadlocked during negotiations. The state's workers' comp system has been fraught with problems in recent years, with a list of medical providers dominated by chiropractors and a dispute resolution system that Rep. Burt Solomons, R-Carrollton, called "an absolute disgrace." The Texas Association of Business reported that medical costs in Texas were running 57-79% above the national average, even with improvements in workplace safety. Complicating matters, the Lege managed to have three different bodies looking at the same issue – a Senate Select Committee, the House Sunset Commission, and the House Business & Industry Committee.

Each group used a different approach – the House thought of workers' comp as a regulated insurance product while the Senate considered it worthy of a stand-alone agency. Each chamber rushed to pass its own version first in order to dominate the discussion, but the ploy backfired when both sides refused to budge. Finally, each chamber chose to substitute their own language into the other chamber's bill, which resulted in some intense conference committee negotiations. After some feverish back-and-forth, the conference committee agreed to accept many of the elements of the governor's hybrid proposal: Workers' comp will be carved out as a department under the Texas Department of Insurance, and benefits will increase by 12%. Stronger incentives and quicker turnaround on payments are expected to expand the network of doctors under the bill. – Kimberly Reeves

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A Little Bit Healthier

Health care advocates say the state provided some growth in health care spending this session, but hardly enough to address the burgeoning needs. The state restored vision, dental, and mental health benefits for Children's Health Insurance Program recipients, but the number is still $20,000 short of last session, says Rep. Garnet Coleman, D-Houston. The state spent another $2.7 billion on Medicaid, but Texas still has more uninsured children than any other state in the country, Sen. Eliot Shapleigh, D-El Paso, said before he cast the only Senate vote against the budget. The Center for Public Policy Priorities calls it a warm day in winter – by comparison to last session, this session's spending may look good, but it's still less than adequate.

On another front, Rep. Dianne White Delisi, R-Temple, passed an alternative model to the controversial StarPlus HMO, which would save the state money but cost local hospital districts in lost federal funds. Delisi's Integrated Care Model would use doctors as gatekeepers to provide greater efficiency in health care. Another controversial bill, HB 470, stalled out. It was expected to privatize mental health care offered by the state, separating the provider-authority roles of the county mental health care authorities. Some considered the provider-authority relationship to be a conflict of interest for counties. Counties, on the other hand, did not want to give up the time and effort put into local health care networks. Author Rep. John Davis, R-Houston, said the issues were too tough to separate, leading to the death of the bill. – K.R.