#atxcouncil: Hospital CEO pushed back on Adler's COVID narrative in real time

"Lying lips are an abomination to the Lord,
But those who deal truthfully are His delight."
Proverbs 12:22

Remember, a couple months back, when the approved narrative was that Austin was going to be overwhelmed by COVID?!?

Yeah, about that:

Pic 1 - CEO of St. David's shoots down Adler's attempt to gaslight and scare the hell out of Austinites in late June. I've also included Adler's initial email in pics 2 and 3. pic.twitter.com/djAEzCzWQV

— johnnyk2000 (@johnnyk20001) September 4, 2020

We actually had some health care industry sources telling us the same thing at the time. of course, that didn't fit the narrative. So nobody listened.

But it's nevertheless interesting that one of the top health care executives in town concurred.

Of course, none of this is surprising.

Bottom Line: While things got tighter for a few weeks, hospital capacity has been fine this entire time.

#TXLEGE: Davis, meanwhile, attempting to set up Health Care Rationing

"having a form of godliness but denying its power. And from such people turn away!"
2 Timothy 3:5

Never let a crisis go to waste:

pic.twitter.com/MtpH0Nc6x2

— Sarah Davis (@SarahforHD134) March 26, 2020

This is actually a couple weeks old (the letter is dated March 20), although we just discovered it this morning.

The problem, of course, is that Davis doesn't propose doing anything to increase the supply of Health Care providers.  She just wants to pour more people (and, one presumes, more money) into the status quo.  In other words, make current challenges worse.

Medicaid already suffers acute shortages.  That's the whole reason why a bunch of left leaning organizations want to scale back (*) scope of practice restrictions.  Yet, Sarah Davis has never lifted a finger on scope of practice (**).

Instead, the medical cartel gets more power.

Bottom Line: Politicians gonna politician, but still....

-------

* - We'd prefer to see scope of practice abolished outright, but the proposals the lege has discussed the past few sessions are nevertheless a gigantic improvement over the status quo.

** - Rumor has it that she's a (very strong) opponent behind the scenes, but to our knowledge she's never said anything publicly.

TPPF, once again, BAILING OUT Texas GOP

"Is it not lawful for me to do what I wish with my own things? Or is your eye evil because I am good?!?"
Matthew 20:15

Inbox this morning:

TPPF Wins Injunction Stopping Dallas Mandatory Paid Sick Leave Ordinance

Federal Judge Holds Dallas Ordinance Violates Federal Constitution and Is Preempted By Texas Law

AUSTIN – A federal judge in Plano issued an injunction yesterday stopping the city of Dallas from enforcing its mandatory paid sick leave mandate that was set to go into effect on April 1.

“Once again, Texas courts are unanimous that it is unconstitutional for cities to mandate paid sick leave,” said Robert Henneke, lead counsel for the plaintiffs in the case and general counsel for the Texas Public Policy Foundation. “These unlawful city policies improperly interfere with the rights of employees to negotiate their own terms of employment. Now is not the time for government to force burdensome regulations upon small business struggling to keep their workers employed and doors open.”

The court found that the plaintiffs had shown a likelihood that the Dallas ordinance violated their Fourth Amendment rights against unreasonable searches and was also preempted by Texas state law.

The court ordered, “The City of Dallas’s Paid Sick Leave Ordinance, Dallas, Texas, Ordinance No. 31181; Municipal Code § 20-1–20-12, is ENJOINED and unenforceable. No officer, agent, servant, employee, attorney, or other person in active concert with the City of Dallas may enforce the Paid Sick Leave Ordinance against any business or entity pending the resolution of this case.”

State courts have previously issued injunctions stopping similar mandatory paid sick leave ordinances in both Austin and San Antonio.

Read the Dallas injunction order in full here:

https://files.texaspolicy.com/uploads/2020/03/31093315/Dallas-grant-of-PI.pdf

We addressed this subject at length a couple of months ago (in the context of the San Antonio ordinance).  We can't add anything.  But we do recommend reading that post.

The TL,DR version is that the lege was supposed to address this last session.  They didn't.  The GOP, from Greg Abbott down, hasn't lifted a damn finger since.

So someone had to pick up the ball.

Bottom Line: Texas is likely to dodge this bullet, no thanks to an of our elected so-called leaders.

TPPF's "Recovery Agenda" Good Place to Start

"But those who wait on the Lord
Shall renew their strength;
They shall mount up with wings like eagles,
They shall run and not be weary,
They shall walk and not faint."
Isaiah 40:31

All of this please:

Recovery Agenda 1 by Cahnman on Scribd

Additional thoughts:

• The federal stuff might be complicated, but there's no good reason for the state stuff to not happen.

• There's a pretty good case to make for completely abolishing the FDA, although dramatically streamlining it might be a more realistic proposal.

• "Eliminate regulations not necessary for public health and safety" = 90%(+) of all regulations.

• Across all levels of government, MASSIVE, unprecedented, deregulation is the only way we'll be able to generate the levels of growth we'll need to climb out of this fiscal mess.

• We're surprised efficiency audits weren't included on this list, because identifying pure waste ought to be step one for climbing out of this fiscal hole.

• We're not sure why "Expanding Telemedicine" falls under the Texas legislature section, because it's our understanding that the primary obstacles are federal.

• "Scope of practice" (ie. Allowing nurses to perform tasks traditionally performed by so-called 'licensed physicians') reform, if not outright abolition, should also be on this list.

• Texas has had applications for Medicaid waivers pending since Dubya's final year in office.

Bottom Line: Most of this should have been done decades ago, but since that didn't happen, no time like the present.

Medical Cartel Trying to Pull Fast One Though State Agency

"They are all adulterers.
Like an oven heated by a baker—
He ceases stirring the fire after kneading the dough,
Until it is leavened."
Hosea 7:4

Via. JoAnn Fleming:

The Good News: After Texans spoke out last month, the Texas Medical Board (TMB) scrapped plans to impose a minimum 10-business-day wait on patients seeking non-emergency care from an independent (out-of-network) physician at any hospital or surgery center in the state of Texas.

The Bad News: The Texas Department of Insurance (TDI) stepped in and imposed a similar rule (applicable to independent physicians at in-network facilities), but without an opportunity for public input. This went into effect on January 1, 2020.

Because the Texas Dept. of Insurance adopted the rule on an emergency basis, there is now a 30-day comment period underway before the rule is adopted as a permanent regulation.

Additional Background: Last year the Texas legislature passed legislation (SB 1264) purporting to address an issue largely caused by insurance companies. The issue has been mislabeled as a problem of “surprise” medical bills. The real “surprise” is that insurance companies deny payment for needed care and add obstacles that prevent and delay patients from obtaining care from the physicians of their choice. Because of your advocacy, and the efforts of Senator Kelly Hancock, the version of SB 1264 that passed contained a good provision preserving the rights of patients and independent physicians to work together without interference from insurance company bureaucrats.

So, what’s the problem?

The TDI is now improperly inserting itself in between patients and independent doctors by implementing a 10 business-day waiting period for non-emergency care for services performed at hospitals and surgery centers. The regulation applies when the facility is in-network according to the patient’s insurance plan, but the physician chosen by the patient is independent (out of network). Currently, there are few facilities that are not run by collaborations between hospital corporations and insurance companies. This rule makes it extremely difficult for a specialist to work at a hospital without being bound to the dictates of an insurance company.

For example: if a patient who is enrolled in a health plan regulated by TDI wishes to contract directly with a surgeon who isn't in the insurer's narrow network, but utilize insurance coverage for hospital or surgery center fees, the patient would have to sign the TDI-approved waiver form, at least 10-business days before the procedure. During this forced waiting period, the patient may suffer in pain or experience worsening disease! That patient’s only other option for care is to agree to be treated by a doctor with whom the insurance company has contracted and who is under the control of the corporate medical system.

Keep in mind that a 10-business-day wait means in most cases at least a 14-day wait and as many as 17 days in situations where holidays add to the delay.

Unelected bureaucrats are attempting to force patients to wait for care from physicians of their choice! Rules like this, if left in place, are yet another step along the path to full corporate and government control of your medical care choices.

Call to Action!

Please take a moment now to speak out against this proposal before the comment period ends. The department will consider any written comments on the proposal that are received no later than 5:00 PM on February 10, 2020.

Your comments can be submitted by email to ChiefClerk@tdi.texas.gov or by mail to the Office of the Chief Clerk, MC 112-2A, Texas Department of Insurance, P.O. Box 149104, Austin, Texas 78714-9104.

The Commissioner will also consider written and oral comments on the proposal in a public hearing under Docket No. 2819 at 1:00 PM on February 4, 2020, in Room 100 of the William P. Hobby Jr. State Office Building, 333 Guadalupe Street, Austin, Texas.

The department requests that parties who plan to speak at the hearing send their written comments (or a summary of their testimony) to ChiefClerk@tdi.texas.gov to facilitate a meaningful discussion.

Attending the hearing? Email Dr. Sheila Page ssheilapage7@gmail.com.

We'd have to re-arrange our schedule to do it, but we're going to try to attend on Tuesday.

Regardless of whether or not you can make it, however, DO e-mail the Department of Insurance.  Obscure government agencies tend to back down when they realize the public is paying attention.  No promises, but the odds are decent.

Bottom Line: Figures they'd try to do something like this while everyone's distracted by the primary.

Chip Roy Might Save the GOP's Bacon on Health Care

"He who despises the word will be destroyed,
But he who fears the commandment will be rewarded."
Proverbs 13:13

We discussed Ted Cruz and Chip Roy's recent Health Care proposal last week; yesterday, Roy discussed it in greater depth at TPPF'S Policy Orientation.

We could say a lot about it.  Obviously, we like it.  But there are a couple of reasons why we think there's a small chance this time *MIGHT* be different.  But the reality is that the only reason either is relevant is because Chip Roy is a member of Congress.

The biggest difference is that somebody is FINALLY talking about fixing the Health Care system.  Not just repealing Obamacare.  Chip Roy (and, belatedly, Ted Cruz) want to actually fix the health care system.

This is something that you can actually take to your friends and neighbors.  Chip Roy's proposal will actually lower your personal health care costs (probably significantly).  Chip Roy's health care proposal will give you more options for how you obtain health care.  No promises, but Roy's health care proposal is also likely to unleash a new round of medical innovation.

This is the first time in 25 years that we can write what we said in the preceding paragraph.

The other reason, perhaps, for modest optimism is that some of the other members of the Texas delegation also seem to get it (on this issue).  Before his panel, Roy was also the lunchtime keynote with Dan Crenshaw.  Obviously, Crenshaw's been a bit of a mixed bag as a Congressman, but Crenshaw and Roy are pulling in the same direction in health care.

Bottom Line: Obviously, a lot remains to be seen, but Chip Roy might just be the man to make it happen.

Cruz and Roy FINALLY do what they should've done FIVE YEARS AGO

"He who despises the word will be destroyed,
But he who fears the commandment will be rewarded."
Proverbs 13:13

TPPF earlier this week:

AUSTIN – The Texas Public Policy Foundation praises the introduction of the Personalized Care Act in the Senate (S. 3112) by Senators Cruz and Braun and in the House (H.R. 5596) this week by Representative Chip Roy.

These concise bills make a substantial impact to the U.S. employer-based health care system by allowing individuals to have the same benefits as employers to buy medical coverage and services with pre-tax dollars.

“Allowing for this equality between employers and employees will help improve portability of coverage for individuals and would free Americans from job-lock of undesirable jobs they are keeping solely for cheaper, employer-based health insurance,” said David Balat, director of the Right on Healthcare initiative at the Texas Public Policy Foundation.

The Personalized Care Act will expand Health Savings Accounts (HSAs) and put millions of Americans in control of their healthcare choices. This will allow Americans to personalize their care with tax-advantaged dollars. Among other enhancements, the bill allows funds from HSAs to be used in coordination for expanded healthcare options such as direct medical care, healthcare sharing ministries, medications, and insurance premiums.

It's ABOUT dadgum time.

Ted Cruz and Chip Roy are two of the GOP's best spokespeople on health care.  They've needed to put out their own plan for a long, long time.  They FINALLY did it!!!

We first discussed this publicly in 2018.  We've been saying the same thing privately for longer.  Although we didn't think it newsworthy at the time, we delivered this message to Cruz personally following a local 2017 event.

Had this plan existed a few years ago, a lot of pain could have been avoided.  The missed opportunity of not doing so remains an act of political malpractice.  But it happened.  All you can do now is correct the mistake moving forward.  This week's news does that.

Bottom Line: Late > Never, etc.

#TXLEGE: Cook Children's "hospital" has plenty of money for lawyers

"It would be better for him if a millstone were hung around his neck, and he were thrown into the sea, than that he should offend one of these little ones."
Luke 17:2

We said our piece about the Baby Tinslee case last week.  We stand by it.  It's the most important takeaway moving forward.

Then this happens:

Today, a judge from San Antonio ruled that a North Texas hospital can stop treating an 11-month-old baby, leaving the baby’s family scrambling to save her life.

Baby Tinslee Lewis, born with congenital heart disease, is currently at Cook Children’s Medical Center in Fort Worth and relies on a ventilator to live. On October 31, despite the objections of her mother, the hospital announced it would remove Tinslee’s ventilator on November 10.

As justification for this decision, the hospital did not provide any reasons relating to bodily health—only a vague “quality-of-life” argument.

The hospital’s action is legal under Texas’ controversial 10-day rule, which allows a hospital committee to end “life-sustaining care” even if the patient, or his or her surrogate, objects; the law also overrides a duly executed medical power of attorney or advance directive from the patient.

Tinslee’s life was temporarily spared when Judge Alex Kim of the 323rd District Court in Tarrant County approved a temporary restraining order filed by lawyers from Texas Right to Life on November 10—the day she was scheduled to die.

However, the hospital dispatched its lawyers to force Judge Kim into recusal, launching a series of harassing subpoenas in an attempt to frame him as being partial.

Though it’s unclear if the subpoenas worked, Judge Kim was ultimately kicked off of the case by out-of-town Judge David Peeples of Bexar County.

Seriously?!?  How much did this cost?!?  Couldn't those funds...cover treatment for an eleven month old girl!?

Money being fungible, etc.

Of course, that's what they didn't do.

Cook Children's "hospital" put the lawyers first.

Quite the statement of priorities.

Do no harm, etc.

Bottom Line: We know the first place we'd look for the funding.

TPPF(tw)!!!

"But as for you, brethren, do not grow weary in doing good."
2 Thessalonians 3:13

[Note: The Texan has more coverage here; the Trib has more coverage here.]

Inbox:

TPPF Victorious in Obamacare Court Case 

Fifth Circuit Court Declares Individual Mandate Unconstitutional 

AUSTIN—Today, the Fifth Circuit Court of Appeals declared that Obamacare’s individual mandate is unconstitutional, agreeing with the argument put forth by the Texas Public Policy Foundation.

“Today’s decision is a victory for the American people and respect for the Constitution,” said Robert Henneke, lead counsel for the individual plaintiffs and general counsel for the Texas Public Policy Foundation. “The court's opinion recognizes that Obamacare continues to injure millions of Americans like our clients who have lost their choice of doctor, suffered rationed care, and had their insurance costs skyrocket. This decision puts us one step closer to eventually freeing the American people from its unconstitutional mandates and regulations. We will continue to fight to protect the rights of families and individuals as the case continues to proceed through the courts.”

It's long (98 pages), but those who are interested can read the full opinion:

Aca 5 Th Circuit Opinion by Cahnman on Scribd

Bottom Line: We had forgotten this case was ongoing, but kudos to the TPPF legal team for their doggedness.

Chip Roy is completely correct

"The rich rules over the poor,
And the borrower is servant to the lender."
Proverbs 22:7

+1:

These spending bills are atrocious. It'll be interesting to watch my Republican colleagues, who look their constituents in the eyes while campaigning on fiscal restraint and a "balanced budget amendment," vote in favor of this package. The party of fiscal restraint ... pic.twitter.com/HOICzkO96i

— Rep. Chip Roy (@RepChipRoy) December 17, 2019

Highlights:

• "This bill doesn't provide anything, the American people provide."

• "This bill borrows."

• "Our nation is $23 Trillion in debt, racking up $100 million worth of debt per hour."

• "This bill is filled with massive policy changes, that we should debate, and vote on, individually."

• "It has a bailout for big insurance."

• "The bill changes the tobacco age nationwide."
• Note: Are you serious?!?

• "Turning Federalism on its head, with nary a whimper from Republicans who like to talk about the tenth amendment in speeches back home."

• "The bill continues the giveaway to big corporations like Boeing in the form of Ex-Im for seven years."

• "The bill funds bureaucrats who wish to target your second amendment rights."

• "It funds abortion through Obamacare plans."

• "The biggest problem is we haven't read the bill."

• "The worst kind of bi-partisanship."

Apparently, this spending bill is longer than the original Obamacare bill.

It's disgraceful.

But kudos to Chip Roy for fighting the good fight.

Bottom Line: There's a reason why Chip Roy is one of the few elected officials that deserves re-election.

First National Conservative Media Outlet, pretty much EVER, Calls BS on Abbott

"Better is the poor who walks in his integrity
Than one who is perverse in his lips, and is a fool."
Proverbs 19:1

One America News is a newer outlet.  To be honest, we're not super familiar.  We do, however, have a couple of business acquaintances who are big fans.

That being said, they've certainly taken the lead on one of the most important stories that needs to reach a broader audience.

In reporting on the Baby Tinslee case, OAN anchor illuminates deeper truths about Greg Abbott and the Texas GOP that can be applied to an number of issues.



Highlights:

• "Republicans in Texas, our eyes are on you."

• "Republicans in the state legislature, Governor Greg Abbott, YOU have the power to repeal this rule once and for all."

• "Governor Abbott, call a special session and repeal this rule."

• TxRTL likewise calling for a special.

• "Call these Texas Republicans out for what they're doing!!!"
• Dear National Conservative Media: MORE OF THIS.

• "Texas legislature, and Governor Greg Abbott, they have the ability to call a special session."

• TxRTL: Abbott "is the only one who has the power to end this right now."

• TxRTL has learned about more cases since the Baby Tinslee case has been in the news.

Bottom Line: We need A LOT more of this, but you've got to start somewhere.

Cook Children's "Hospital" conforms to WRETCHED Stereotypes

"Rejoice and be exceedingly glad, for great is your reward in heaven, for so they persecuted the prophets who were before you."
Matthew 5:12

This is astounding:

Lawyers from a Fort Worth hospital are harassing a conservative organization in North Texas as part of their plan to combat a judge’s interference in killing a 9-month-old baby.

Tinslee Lewis was born with congenital heart disease. She is currently at Cook Children’s Medical Center in Fort Worth and relies on a ventilator to live. On October 31, against the objections of Tinslee’s mother, the hospital announced it would remove the ventilator from Tinslee on November 10, thus killing her. No reasons relating to bodily health were given by the hospital. Instead, only a vague “quality of life” argument was provided.

The action by Cook Children’s is legal under Texas’ controversial 10-day rule, which allows a hospital committee to end “life-sustaining care” even if the patient, or his or her surrogate, objects; it also overrides a duly executed medical power of attorney or advance directive from the patient.

Tinslee’s life was temporarily spared when Judge Alex Kim of the 323rd District Court approved a temporary restraining order filed by lawyers from Texas Right to Life on her behalf on November 10—the day she was scheduled to die. A hearing originally set for November 22 was postponed until December 10 after the hospital dispatched its lawyers to try and force Judge Kim to be recused.

The lawyers have now issued a subpoena to True Texas Project, the North Texas grassroots activist organization—formerly known as Northeast Tarrant Tea Party—led by Julie White McCarty. The subpoena contains a draconian list of communications to be turned over to them, including:

• All documents and communications related to any endorsement of Judge Alex Kim’s judicial campaign by True Texas Project. 

• All documents and communications related to any contributions True Texas Project made to Judge Alex Kim’s judicial campaign.

A similar subpoena was given to Empower Texans, the publisher of Texas Scorecard. The subpoenas included a deadline for compliance of less than 48 hours during the week of Thanksgiving.

Because nothing screams "everything we're doing is on the up and up" quite like attempting to sue your critics into silence.

Which is a shame.

Here's the secret: This type of care is extraordinarily expensive.  Hospitals frequently eat that cost.  These are some of the most challenging examples of what the industry calls "indigent care."

It's not an objection to which we are entirely unsympathetic.  A conversation about how to pay for this sort of treatment probably should.  There's got to be a better way.

But then they do something like this.

Cook Children's "Hospital" can find the money to sue their critics...but they can't find the money to treat a little girl?!?

It's quite something.

It also makes one wonder what else they're hiding.

Bottom Line: At a minimum, the optics are terrible...and it's probably worse than that.

#TXLEGE: One interesting, modestly positive, note deeper in the budget

"Wealth gained by dishonesty will be diminished,
But he who gathers by labor will increase."
Proverbs 13:11

From the Trib story on Abbott signing the budget:

Other portions of the budget didn’t see as much growth. The $84 billion for health and human services programs is up just 1% from the last two-year cycle, and Medicaid, the federal-state health insurance program for the poor and disabled, is facing a $900 million cut.

[Note: Emphasis added.]

Hmm....

What's interesting about this is, for as much of an insaneo spending spree as they went on over education, there was no equivalent on health care.

From a macroeconomic perspective, if the state were to get serious about health care and Medicaid costs, conceivably we could absorb a rather large increase in education spending.  That's not to say that the other problems in the system would go away.  But it is to say the impact on economic growth could be contained.

Of course, all of this would require several years to play out.

Bottom Line: Probably won't amount to much, but it is a situation worth keeping an eye on....

#TXLEGE: Alliance for...enabling bureaucrats over patients?!?

"They are all adulterers.
Like an oven heated by a baker—
He ceases stirring the fire after kneading the dough,
Until it is leavened."
Hosea 7:4

Over the past week, we've seen movement to reform the diabolical Texas "Advance Directives" Act.  Mind you, this is reform, not repeal.  The bill in question leaves the wicked system in place.  It merely establishes a more workable system of 'due process' for those already trapped.

Furthermore, the horrifying Carolyn Jones case happens in the background.

Yet, even this modest concession is too much for some:

SB-2089-opposition-letter-4... by on Scribd

Obviously, that letter has a lot to unpack, but to yammer about "imminent and certain death" at a time when a Beaumont woman is heroically disproving their argument tells you what you need to know.

Something else in that letter speaks louder:

Wow.

For those of you unfamiliar with the history, the so-called Texas "Medical" Association has been one of the...more zealous advocacy groups for abortion in this state.

Yet an allegedly pro-life group treats them like BFF's.

At least the so-called Texas "Medical" Association has a certain 'logic.'  They're a trade group.  As such, their objective is to preserve their own pricing power.  Given this objective, it doesn't take a genius to see why they support bureaucrats over patients.

Their logic might be diabolical.  Their logic might be wicked.  But their logic IS logical.

We can't say the same for any self-respecting "pro-life" organization.

Obviously, end of life decisions are difficult.  But that's why those decisions should be made by patients and families.  Not bureaucrats backed by the force of an obscure state law.

Which, of course, is obvious to anyone who calls themselves pro-life and has a shred of integrity or self-respect.

Unfortunately, not everyone in this state who markets themselves as "pro-life" has those traits.

Bottom Line: The correct pro-life position in this case is obvious to anyone who isn't willfully blind or hopelessly compromised....

#TXLEGE: Repeal THIS protectionist racket for a small-ball health care win

"Now to Him who is able to do exceedingly abundantly above all that we ask or think, according to the power that works in us,"
Ephesians 3:20

Did you know that Texas has some of the most restrictive laws on who can provide medication in the country?!?  Neither did we, until we attended this afternoon's TPPF event: "Physician Dispense Laws: Can Texas Make Medications More Affordable?" Texas is worse than California on this.

Currently in Texas, if a Doctor writes a prescription, the patient is required by law to make a separate trip to a pharmacy to fill the prescription.  This despite the fact that it's legal in 46 other states for a doctor to dispense medication in their office.  That's asinine, and it drives up costs to consumers.

In some cases, those cost increases are dramatic: Panelists mentioned cost escalations of 60% to 80% on some drugs.

Fortunately, there's hope: HB 460, by Matt Shaheen, would address this issue.  The bill was heard last week.  It's currently pending in committee.

Shaheen specifically asked the public to talk to members of the Public Health committee.  Senfronia Thompson is chair.  We'll post her office contact info below.

If we're ever going to fix the health care system, this sort of small-ball effort is how you build the credibility necessary for that sort of undertaking.

Bottom Line: Honestly, the fact that California is better than us on this issue speaks for itself.

--------

Representative Senfronia Thompson:
Chair, House Committee on Public Health
(512) 463-0720

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Minjarez Physician Dispense... by on Scribd

#TXLEGE: House budget proposed CUTTING health care (plus other notes)

"Every prudent man acts with knowledge,
But a fool lays open his folly."
Proverbs 13:16

The House released their budget proposal yesterday.  Obviously, the headlines have been all about the education number (more on that below).  But we noticed something else quite interesting:

Notably, the House budget decreases state funding for health care and human services by about 3.2 percent. Education and health care make up the vast majority of state spending.

[Note: Emphasis added.]

This is interesting.  Medicaid/health care has been the fastest growing component of the state budget for decades.  Getting Medicaid under control could, conceivably, free up money for other items.  This is something for which we've been advocating for years.

At a minimum, it suggests that the House is willing to set priorities.  Yes, they plan to spend more state funds on education.  But, in order to get there, they're going to take the money from elsewhere in the budget.  That would never have happened under the previous house leadership.

As for the education number: It's the beginning of a negotiation.  They asked for a (very) big number.  Don't read too much into this (at least for now).

For now, that the House is willing to cut Health Care is much more important that whatever the final education number might be.

Then there's this:

House budget includes 10% pay raise for state district judges.

If this is OK'd, it means lawmakers would also get a pension boost b/c their pensions are tied not to #txlege pay but the pay of, you guessed it, state district judges.

Background: https://t.co/lHnuZEDWsv pic.twitter.com/QIwAxU5CKu

— Lauren McGaughy (@lmcgaughy) January 15, 2019

Obviously, it should take more than a single tweet from a DMN reporter before people blow a gasket.  But this warrants monitoring.  We'll certainly see.

Bottom Line: Obviously, it's early.  Obviously, we'll have to wait and see.  But for the House to take this type of a stand, this early, over health care is new....

#TXLEGE: 4 issues on which a forward looking Texas GOP really OUGHT to engage

"And let the beauty of the Lord our God be upon us,
And establish the work of our hands for us;
Yes, establish the work of our hands."
Psalm 90:17

With the lege returning tomorrow, we suggest that the following lower profile issues will have outsized economic (*) impact over the next decade:

1. Housing Costs -- Housing costs are the largest line item in most household budgets.  Finding an affordable place to live is one of the biggest challenges Americans under 40 face.  While Texas is in better shape than most locations, worrisome trends are emerging (starting with, but not limited to, Austin).
   
   Government policies such as restrictions on permitting and zoning artificially  limit the supply of housing, which drives up cost.
   
   As a bonus, free-market housing policies could also unshackle capital currently tied to Texans primary residence.  Imagine what you would do with the money if your housing costs were less than 10% of your income.
   
2. Tuition Costs -- Ending the ability of public universities to raise tuition willy-nilly is a precondition for all other higher ed reforms.
   
   It's also a large expense for Texans under 30.
   
   Likewise, reigning in university tuition could unshackle capital currently tied to tuition payments/servicing student loans.
   
3. Health Care small ball -- While federal reform will continue to remain elusive, the Texas can still remove state level supply restrictions.
   
4. Occupational licensing -- If you want people to become productive members of society, requiring them to get permission from the government to work doesn't help.

Bottom Line: This is low hanging economic fruit.  We don't promise anything, but it might be similar political fruit.  Will anyone pick it?!?

------

* -- Note: There's a decent chance these issues also pay political dividends, but no guarantee.

Did Cornyn just, unintentionally, open up a new lane for a primary?!?

"Let nothing be done through selfish ambition or conceit, but in lowliness of mind let each esteem others better than himself."
Philippians 2:3

On Monday, the Ft. Worth Star-Telegram ran a hatchet job story about how Texas' federal officials are reacting to the state level lawsuit against Obamacare.

From John Cornyn:

“People ought to just take a deep breath and see what the Supreme Court does, maybe in a couple years from now,” said Sen. John Cornyn, R-Texas, the second-ranking Senate Republican. He’s up for re-election in 2020.

In other words, John Cornyn wants to do ** LITERALLY NOTHING** to address health care until some vaguely defined point in the future.

How typically Cornyn.

Of course, whatever baggage exists from the health care fights of the past decade, none of it changes the fact that health care remains one of the biggest economic/social policy challenges we face.

Sure would be nice if our elected officials would address it.

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That being said, Cornyn's admission he's comfortable with the status quo creates an opportunity.

If a credible candidate were to challenge Cornyn on a platform of fixing the health care system...it just might work.

Such a campaign would be forward looking.  It wouldn't be about punishing the mistakes of the past.  It would be about seizing the opportunities of the next decade.

Such a campaign also wouldn't, really, be about Cornyn.  It would be about fixing one of the biggest economic challenges Texans face.  To the extent Cornyn was discussed, it would be more in sorrow than in anger.

The temptation is to go after Cornyn as a traitorous RINO.  That's because it's true.  But that sort of messaging has a ceiling, and that sort of campaign would be doomed to failure.

Earlier this month, we splashed cold water on the idea of a Cornyn challenge.  But that's a Cornyn challenge in the context of the preceding paragraph.  What we're talking about now is different.

A disciplined, forward looking, campaign to fix the health care system might just work.

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It should be noted that we don't have a clue who to run as a candidate.

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Bottom Line: Based on his comment Monday, Cornyn clearly isn't interested in moving the ball forward on health care.  But the public still cares about that issue...a lot.  If a credible candidate were to credibly address the issue, it just might work.

#TXLEGE: Texas' Obamacare Victory Opens INTRIGUING Possibilities

"And let us not grow weary while doing good, for in due season we shall reap if we do not lose heart."
Galatians 6:9

Via Lauren McGaughy:

AUSTIN — Gov. Greg Abbott said Texas will work to pass its own health care law to replace the Affordable Care Act if it's ultimately struck down in the courts.

After Friday's ruling by a Fort Worth judge that struck down the federal health care law, Abbott said Monday he will consult with the Trump administration on immediate next steps while state lawmakers and regulators fashion their own plan to succeed it.

"As the ACA lawsuit goes through the appellate process, Texas will work with the administration to get appropriate waivers from federal law allowing insurers to provide coverage at lower rates while ensuring that Texans with pre-existing conditions continue to have access to quality health care," Abbott said.

"Additionally, Texas will begin the process of reforming state regulations and proposing changes to laws that will achieve those same goals. Importantly, Texas will strive to expand health care insurance coverage, reduce the cost of health care and ensure that Texans with pre-existing conditions are protected."

Abbott then tweeted Texas would "be ready with replacement health care insurance that includes coverage for preexisting conditions."

....

"It's time to get started now, not to wait for the ultimate outcome of this case," Rob Henneke, general counsel of the Austin-based Texas Public Policy Foundation, said in a call with reporters Monday morning. When Texas lawmakers convene their 2019 session in January, he said, they should be "looking at the issue of pre-existing conditions. We need to look at ways of creating guaranteed-protection pools."

Henneke added that states should prioritize "market-based solutions but also regulations that will provide for choice."

Good.  The Texas GOP's lack of vision on health care has been driving this author insane for several years.  This is true at both the state and federal levels.

Obviously, the medical establishment will fight reform.  But...so what?!?  In the language of godawful Capitol euphemisms, now is the time to "begin the conversation."

Then there's the fact that, you know, lack of vision on health care played a role in the Texas GOP's loss of standing with suburban voters.

Bottom Line: Last friday's ruling offers the Texas GOP an opportunity to make tangible progress towards health care freedom.  They should take it.  They might even discover voters like those sorts of things....

Texas [Insert Health Care Pun] against Obamacare!!!

"And let us not grow weary while doing good, for in due season we shall reap if we do not lose heart."
Galatians 6:9

FANTASTIC:

Fort Worth-based U.S. District Judge Reed O’Connor on Friday ruled that a major provision of the Affordable Care Act is unconstitutional — and that the rest of the landmark law must fall as well.

In February, a Texas-led coalition of 20 states sued the federal government to end the health care law in its entirety, arguing that after Congress in December 2017 gutted one of its major provisions, the rest of the law was unconstitutional. The U.S. Supreme Court had upheld the law because its individual mandate — a financial penalty for not having insurance — could be interpreted as a tax. But after Congress set that tax at $0, the Texas coalition claimed the rest of the law no longer had “constitutional cover.”

O’Connor sided with Texas, ruling that the individual mandate was rendered unconstitutional. That portion of the law, he argued, is not severable from other provisions, and so the rest of the law must fall.

Honestly, this should be a no-brainer.  Obamacare was originally upheld as a tax.  That tax is gone.  Case closed.

That being said, don't ever underestimate John Roberts' willingness to invent rationalizations for this wretched law.  That's why the "tax" argument emerged in the first place.  It will be interesting to see into what new intellectual pretzels John Roberts might twist himself.

TPPF has more:

“Today’s historic win striking down Obamacare is only the first step,” said Robert Henneke, general counsel and director of the Center for the American Future at the Texas Public Policy Foundation. “We need to focus on the future and look to states like Texas to lead in restoring the relationship between doctor and patient, unencumbered by government and insurance company red tape. Let’s focus on solutions that will drive down costs and restore choice in doctor.”

Please, make it so.

Bottom Line: Health care freedom requires an unencumbered relationship between consumers and providers.  Yesterday's ruling was a necessary, but insufficient, step in that process.  Kudos to Paxton and TPPF!!!