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Charles Schwertner

Ending exemptions for vaccines

Hear, hear.

A Texas Republican is taking aim at a provision in state law that allows parents with personal or religious objections to vaccines to opt their children out of school immunization requirements.

State Rep. Jason Villalba, R-Dallas, said Friday he will soon propose legislation to eliminate what are called “conscientious exemptions” because of the reemergence of diseases like measles and whooping cough attributed to growing numbers of parents choosing not to vaccinate their children.

“We are just saying, ‘Look, if you are going to send your children to public schools, they need to be vaccinated,'” he said. “We are going to ask that you keep other children safe.”

The measure, which Villalba said he would file next week, comes as several other states are reevaluating their immunization laws as they battle a measles outbreak linked with exposure to an unvaccinated woman in a California amusement park.

Texas is among 20 states that waive school vaccine requirements because of personal beliefs, according to the National Conference of State Legislatures. All but two states — Mississippi and West Virginia — grant exemptions from school immunization requirements on religious grounds.

Under Villalba’s proposal, Texas would not allow an exemption for either of those reasons. Students would still be able to receive medical waivers, which doctors grant in cases where an allergic reaction or a weakened immune system could cause health complications.

As you know, I’m down with this. Texas’ overall rate of getting exemptions isn’t that high, but in some places it is. That’s an outbreak waiting to happen, so I hope the rest of the Lege falls in behind Rep. Villalba’s bill when it is filed. On that score, the Senate may be a challenge.

Even with a measles outbreak dominating headlines, don’t expect an avalanche of immediate support for a high-profile idea to cut down on the ability of Texas parents to opt their children out of school immunization requirements.

Two state Senate committee chairmen told the Houston Chronicle they have hesitations about a bill that state Rep. Jason Villalba said Friday he plans to introduce to eliminate religious and philosophical exemptions to the requirements.

State Sen. Charles Schwertner, R-Georgetown, who leads the Health and Human Services Committee, said through a spokesman that while he views vaccines as a “critical component of protecting the public health…(he) would prefer to increase education about the safety of these vaccines rather than imposing new mandates that would ask Texas parents to act against their own conscience or their deeply-held religious beliefs.”

The chairman of the Senate education committee, Republican Larry Taylor of Friendswood, offered a more moderate response but noted that in Texas, “there is also a long standing tradition of giving parents the right to make decisions regarding their children’s healthcare.”

“I stand ready to hear parents’ and legislators’ opinions on this very serious issue,” Taylor said.

I hope he’s also ready to hear doctors’ opinions, too. California’s legislature is taking similar action, as are legislatures in several other states. Hopefully, at least one good thing will come out of the Disneyland measles epidemic of 2015.

Tuition re-regulation on the menu

There are different ways it could go.

Sen. Charles Schwertner

Tuition at Texas universities has more than doubled in the 12 years since state lawmakers authorized colleges to set their own rates.

Now legislators are pushing to take back that control. It’s not a new idea, but it stands a chance for the first time since 2003, when the state deregulated tuition, largely because it enjoys rare bipartisan support.

At least three lawmakers, including Houston Democrat Sen. Rodney Ellis, have filed bills to re-regulate tuition in some way. The chair of the Senate’s higher education committee Kel Seliger, an Amarillo Republican, plans to pitch tying tuition increases to performance by colleges – essentially making them earn a tuition bump. And Dan Patrick, the state’s new lieutenant governor, said last week that the “issue will be addressed this session.”

“It marries together Democrats, who want to make higher education more affordable, and tea party conservatives who are inherently suspicious of higher education,” Rice University political scientist Mark Jones said. “In some ways this is a way for the Legislature to do something about education, but with relatively low cost.”

[…]

Deregulation essentially transferred costs to the universities and their students. That’s something Texas and other states have done for decades.

A recent report by the U.S. Government Accountability Office says students are now paying public colleges more than the states are. Tuition accounted for 25 percent of the average public colleges’ revenue in 2012, up from 17 percent in 2003, the study found. That surpassed state funding, which accounted for 23 percent of schools’ budgets in 2012.

Texas now funds less than 20 percent of the University of Texas at Austin’s budget, for example, compared to 85 percent in the 1970s. State funding accounts for 22 percent of UH’s budget now, compared to 61 percent in 1985. Students now pay for 42 percent of the budget, compared to 11 percent 30 years ago.

[…]

While Ellis says he will advocate for additional funding for higher education, his bill to end deregulation is actually the stricter of the two senate bills that have been filed so far, because it would cap tuition at 2015 rates and require universities to get legislative approval to raise it. Mary González, a House Democrat from Clint, has proposed a similar bill.

The other Senate bill, by Schwertner, would allow for annual tuition increases based on inflation. Ellis and Schwertner have talked about finding a compromise bill, but Ellis said last week that he wouldn’t support inflation-based increases, which he said is “almost like institutionalizing the thievery from middle class families.”

The third possible route to re-regulation could fold in another popular higher education proposal: tying funding for universities to performance measures such as graduation rates. Seliger said he plans to file a bill that would tie tuition increases to those performance measures. He calls it “performance-based tuition.”

Seliger pointed out that while tuition has increased at a faster clip since deregulation, lawmakers weren’t doing much to keep it down before. From 1994 to 2002, tuition and fees went up 102 percent.

“It was still increasing at a pretty good rate, because people wanted to see universities make big increases in improvement,” he said.

See here for the background. Sen. Schwertner’s bill is SB233. Neither Sens. Ellis nor Seliger have filed their bills yet, but Sen. Ellis’ bill from 2013 was SB125; I would presume what he files this year is identical or almost identical to it. I prefer his approach, because the problem is that the state is not contributing enough to cover the cost of higher education. That was the deal made to cut costs in 2003; it was rotten then, and it’s rotten now. I don’t expect Sen. Ellis’ approach to be adopted, but now that Republicans have come to regret their past actions – most likely because they’ve finally started hearing it from their constituents – I have some hope that he and Sen. Schwertner can work out a deal that at least comes closer to his approach.

UPDATE: As noted in the comments, Sen. Ellis’ bill is SB255.

Some Republicans embrace tuition re-regulation

This is a welcome change, but let’s not be distracted by what isn’t being said.

Sen. Charles Schwertner

Tuition and fees at the state’s public colleges and universities would be capped at their current levels and only be permitted to grow at the rate of inflation under a bill filed Tuesday by state Sen. Charles Schwertner, R-Georgetown.

Schwertner telegraphed his filing of Senate Bill 233 for the 2015 legislative session in a Sunday column in TribTalk. In the column, he argued that because state lawmakers started allowing university governing boards to set tuition rates without legislative oversight in 2003, “the dream of attaining a college degree is becoming a nightmare for more and more Texas students.”

Average tuition and fees in the state have more than doubled since tuition was deregulated and, as Schwertner noted in a news release announcing his filings, that growth has significantly outpaced the rate of inflation.

“I think the Legislature has a responsibility to consider whether the deregulation policies enacted over a decade ago still make sense for Texas students,” he said in a statement Tuesday.

Here’s that press release from Sen. Schwertner referenced in the story. I’m glad to see some Republican acknowledgment of this problem, but if you read Schwertner’s TribTalk piece and you’re old enough to remember the year 2003, you will note what is prominently missing from his words: The fact that tuition deregulation was passed by Republicans at that time as a way to deal with a budget shortfall by allowing the public universities to set their own tuition rates in return for getting less funding from the state. If Schwertner and Greg Abbott are truly serious about this, they will acknowledge that simply capping tuition without making up the reduction in state funding for public higher education will cause other problems and is just shirking responsibility altogether for those problems. This is a good start, and kudos to Schwertner for being the point person for it, but it’s only part of the puzzle.

Democrats, at least the ones that weren’t in then-Speaker Tom Craddick’s pocket in 2003, opposed tuition deregulation and have fought to repeal it since then for precisely the reasons laid out by Schwertner, with the crucial difference being that they support the state paying its fair share. A Legislative Study Group report on higher education that I linked to in 2008 but which is unfortunately not at that URL any more covers a lot of this ground. Note the line about California having ten tier one universities that Abbott alluded to the other day. That LSG report also included an op-ed by Rep. Garnet Coleman from 2004, in which he correctly predicted everything that’s now finally being acknowledged today. Here’s an excerpt:

Gov. Rick Perry and House Speaker Tom Craddick exerted unyielding political pressure to compel the tuition deregulation bill’s passage, using Texas’ $10 billion budget shortfall as the rationale. While top state officials were patting themselves on the back for not raising taxes, they were saddling Texas college students and their families with staggering hikes in tuition rates.

Perry claimed in his State of the State address that education represents the greatest investment we can make in a future of prosperity. He then agreed to slash general revenue funding for higher education by $259 million, which includes his veto of $55 million for excellence in research funds. Yet, the governor simultaneously fought for and received $295 million for a new, unproven economic development fund that allows him to hand out financial incentives to businesses he is attempting to lure to Texas.

[…]

Knowing that it would further strain the ability of many students to pursue a college education, our short-sighted leaders forged ahead with their plan to deregulate tuition. Students holding jobs to pay for their college education will be required to work longer hours or take out additional student loans to cover the costs of unchecked tuition increases.

For example, tuition rates are set to rise by an average of approximately 12 percent this spring at the University of Texas System’s institutions. A student taking a 15-hour course load at the system’s flagship institution, the University of Texas at Austin, faces an even greater increase of 26 percent. By fall, the same student will pay 52 percent more for tuition than he did the previous year.

One major flaw of tuition deregulation is its affect on older students. Proponents of this policy failed to consider the fact that not every Texas university is a flagship and not evey student is a fresh-faced recent high school graduate. At the University of Houston at Victoria, for instance, the average attendee is 33. Increased costs are especially devastating to these nontraditional students who already have jobs, families and other responsibilities. Many cannot afford the extra burden.

Tuition deregulation also has serious consequences for two popular state programs, the Texas Guaranteed Tuition Plan and the Texas Grants Program. Parents and grandparents who were planning on securing a college education for their children and grandchildren by locking in tuition rates through the Texas Guaranteed Tuition Plan (formerly the Texas Tomorrow Fund) will no longer have that opportunity. Recent tuition spikes and uncertainty about future tuition costs have forced that program to close its doors to new enrollees.

Additionally, fewer Texas students will receive grants from the state to offset tuition costs. Without even taking into account the impact of deregulating tuition, the Texas Higher Education Coordinating Board already projects a 12 percent decline in Texas Grants recipients by 2005. Tuition hikes across the state will further diminish the number of new recipients.

Again, that was written in 2004. As is so often the case, we should have listened to Rep. Coleman. It took a decade longer than it should have, but we would be well advised to listen to him now.

It’s still not Medicaid expansion

The Legislature may do something that could sort of be called “Medicaid expansion”, if only for lack of a better term, but we would all do well to remain deeply skeptical of what they might consider.

It's constitutional - deal with it

It’s constitutional – deal with it

The once taboo subject of expanding Medicaid in Texas has been broached in recent weeks by some Republicans and GOP-friendly organizations, as the Legislature prepares to reconvene early next year.

[…]

In 2013, state Rep. John Zerwas, R-Richmond, wanted to use federal dollars and a Medicaid waiver to create a new insurance program for poor Texans, but he was never able to build much support among his Republican colleagues.

“Last time, everybody was pretty reactionary,” said Zerwas, a physician. “We were playing defense.”

But with Perry leaving office in January and a new legislative session set to begin, Zerwas and his allies once again are pushing for a new program.

The difference this time is the dialogue is more thoughtful and the effort is more organized, he said.

Zerwas and other legislators had the chance after the 2013 session to go back to their districts and listen to their constituents. Many expressed interest in insuring people who can’t get coverage under the new law, he said, but many more have indicated that they want to see the already stressed, safety-net hospitals get some relief from being forced to care for so many uninsured people.

Gov.-elect Greg Abbott said on the campaign trail that he opposed Medicaid expansion, but spoke of seeking a block grant from the federal government to reform Medicaid in the state, echoing some other Texas Republicans.

The words “block grant” are your first clue that despite the sincere words of people like Rep. Zerwas, this is the same old song and dance with some fresh wrapping paper on it. Block grants are a shibboleth and a mirage. The Bush administration refused to grant waivers to allow for these things. President Obama will nominate Ted Cruz to be its next Attorney General before his administration will consent to block grants for Texas.

The Texas Association of Business, an influential group with close friends in the Republican Party, has come out again in support of expanding Medicaid, just as it did in 2013.

Bill Hammond, president of the organization, said it will take a “massive effort” in 2015 to increase coverage for Texans, but it’s a fight he is willing to take on.

“It just makes sense for us from the business perspective,” he said.

[…]

Dan Stultz, president and CEO of the Texas Hospital Association, said in a presentation that hospitals need meaningful coverage expansion.

Stultz told the Associated Press earlier this year that hospitals agree with Perry that the Medicaid program is “severely flawed,” but he also said that “without the Medicaid expansion, many will remain uninsured, seeking care in emergency rooms, shifting costs to the privately insured and increasing uncompensated care to health care providers.”

The Texas Medical Association, one of the most powerful lobbies in state government, also supports allowing state leaders to work with the federal Centers for Medicare and Medicaid Services to come up with a solution that fits Texas’ health care needs.

The association’s leaders are pushing the Legislature to create a concept, as it says on the group’s website, that “works for the state and helps Texans in the coverage gap get affordable and timely care.”

The “support” these organizations have for Medicaid expansion doesn’t extend to supporting candidates that support Medicaid expansion, of course. In that way, it’s like their support of immigration reform. Fill in your own definition of insanity, and go search healthcare.gov for insurance policies that would cover that affliction.

Be all that as it may, we now have an interim report with recommendations on the subject.

Texas should pursue a waiver from the federal government for more flexibility to administer Medicaid, heighten the “visibility” of the state’s mental health programs to “ensure adequate leadership and accountability” and consolidate its three major women’s health programs, the Senate Committee on Health and Human Services said Monday.

In a lengthy report, the interim committee released its recommendations for the 2015 legislative session, addressing charges from outgoing Lt. Gov. David Dewhurst to expand access to women’s healthcare, improve the state’s mental health services, stop prescription drug abuse, and provide affordable care options for the state’s uninsured — all under the constraints of a fiscally conservative budget.

[…]

Among the report’s other recommendations:

Texas should not expand Medicaid to cover low-income adults, a key tenet of federal health law. Lawmakers should, however, seek to renew the “transformational” Medicaid waiver that, among other things, helps reimburse hospitals for the emergency care they provide to the uninsured. Notably, the report does not rule out pursuing a transformational waiver like the one the feds approved in Arkansas, which provided for a private health coverage expansion to low-income people using the Medicaid expansion dollars made available under the Affordable Care Act.

See here for some background, and here for a copy of the report. Rather than get distracted by shiny objects, read these two paragraphs from page 23:

The state’s first order of business must be to repair this broken Medicaid system and bring these costs under control. By enacting common-sense reforms such as cost sharing, health savings accounts, variable benefit packages, and high-deductible emergency care plans, Texas can reform its Medicaid program in a way which contains costs, encourages personal responsibility, and lessens the burden of providing uncompensated care.

Unfortunately, most of these innovative solutions are not able to be implemented under the strict Medicaid guidelines imposed by the federal government. By receiving a federal waiver from these restrictions, Texas can finally have the flexibility it needs to design a sustainable and cost-effective Medicaid program that is appropriate for the citizens it serves and accountable to taxpayers.

Like I said, let’s keep our eyes on the ball. The feds have been making noise about that “transformational” waiver not being a guarantee if Medicaid isn’t expanded in some acceptable form. What “acceptable” looks like is the hundred billion dollar question. The feds have been fairly accommodating to recalcitrant states, but there’s only so far they’ll go. Block grants ain’t happening, and those pet rocks masquerading as “common sense reforms” are more smoke than substance. Texas is going to have to give something to get something, and I’ll believe that will happen when I see it. A press release from Sen. Charles Schwertner, the chair of the HHS committee, is here, and Texans Together has more.

Just don’t call it “Medicaid expansion”

It’s the public policy that dare not have its name spoken, at least by Republican legislators.

It's constitutional - deal with it

It’s constitutional – deal with it

State lawmakers renewed efforts Thursday to find a “Texas solution” to expand health-insurance coverage for low-income residents without accepting the Medicaid expansion in President Barack Obama’s signature health care law.

Social-services advocates and local officials are among those pushing for a compromise measure that gives the state more flexibility than in the law to spend the money available from the federal government to cover more residents.

On Thursday, the state Senate Health and Human Services Committee met to “start a conversation that will give us an accurate picture of who the uninsured are, what services are available to them and what we can do to help them,” said chairman Charles Schwertner, R-Georgetown.

Katrina Daniel of the Texas Department of Insurance said about 6.5 million state residents do not have health insurance, although some of those can afford insurance and have chosen not to purchase it. An estimated 1.3 million uninsured Texans earn less than the federal poverty level, leaving them in the so-called “coverage gap.” The president’s law assumed all states would expand Medicaid, so it left those eligible for Medicaid out of its subsidies to help poor residents buy insurance.

Caring for those and other uninsured residents is costing counties billions of dollars a year, according to a letter sent to Schwertner on Wednesday by the judges in Harris, Bexar, Dallas, Tarrant, Travis and El Paso counties.

“We write not to complain about this fiscal burden or duty, but to urge your committee to use this interim to find a Texas way forward to fund and increase access to healthcare coverage for low-wage working Texans,” the judges wrote.

Two of those county judges are Republicans, of course, and frankly I think they have every right to complain. The cost of health care for those uninsured people comes out of their budgets, not the state’s. A lot of that cost includes treatment for folks with mental illness, who generally get that treatment in county jails. Medicaid expansion solves a whole world of problems, we just have to be smart enough to take it. If that means calling it something else, or coming up with something that’s almost but not quite exactly Medicaid expansion so we can claim it’s a “Texas solution”, then so be it. Either is better than what we’re doing now.

From the files of privatization failures

A story from last week.

State officials have decided to slow the rollout of a controversial overhaul of the foster-care system after the private contractor running a pilot program abruptly pulled out Friday.

Judge John Specia, commissioner of the state Department of Family and Protective Services, said a second pilot of the overhaul will continue but other planned expansions will not move forward until his agency studies what went wrong.

“It would be foolish of us to not look at this situation, look at the contract being terminated, talk to the legislative leadership, talk to the providers and advocates and then fully make a decision about moving forward,” said Specia, hours after receiving notice that Providence Service Corp. intended to opt out of a five-year contract after just 18 months. “That’s necessary at this point.”

Lawmakers said the cancellation of the contract would force them to take a closer look at the overhaul, called “Foster Care Redesign.” There will be no disruption of services for the children, as the state will take over the work after a transition period of at least 30 days.

But the development marked a setback for the “redesign” program, which was approved in 2011 as a way to improve the system without increasing costs.

[…]

“As we move forward, the Legislature should carefully examine whether Foster Care Redesign still represents the best solution to the challenges facing our state’s foster care system,” said state Sen. Charles Schwertner, a Georgetown Republican who chairs the Senate Health and Human Services Committee.

Providence, based in Tucson, Ariz., had been failing to meet some of its performance metrics and recently unsuccessfully sought more money from the state, officials said.

Mike Fidgeon, the company’s chief operating officer, said it had proved impossible to provide services for roughly 1,100 children in the pilot’s 60 West Texas and North Texas counties without spending more than the state had spent in previous years, as the contract required.

“The contract guiding us doesn’t adequately address the needs of the children and families,” Fidgeon said. “The most responsible way forward is to conclude the current arrangement and work to help the Legislature more adequately fund the state’s foster care system.”

Providence started work last February after winning its $30 million annual contract. ACH Child and Family Services of Fort Worth was tapped for a second pilot, in Tarrant and six nearby counties. More contracts were expected to be put out to bid soon.

But Providence struggled from the start to produce better outcomes or even stay afloat financially.

Emphasis mine. Funny how these things work, isn’t it? The free market can always do it better and more cheaply than the government, and spending must always be cut. It would be funny if there weren’t real people – children, to be specific – on the business end of it. The Legislature created this mess as part of its orgy of budget slashing in 2011, the Legislature can figure out how to fix it. See this Observer story from May for more.

You can’t undo the damage to women’s health

At the very end of this story, in which Rep. John Zerwas and Sen. Charles Schwertner, both of whom are physicians in real life, say that they (mostly) stand with Rick Perry on not expanding Medicaid, they also say this:

Regarding the budget cuts in the last legislative session to family planning and women’s health care, both lawmakers said they support an initiative this session to restore funding by way of primary care programs.

“We’re going to recommend a funding level for [women’s health] … at about 50 percent higher than what they had originally asked for,” Zerwas said.

That’s mighty big of them, isn’t it? We’ve also recently heard about some similar sentiments elsewhere in the Senate:

Health and Human Services Committee Chair Jane Nelson, R-Flower Mound, touted a recommendation Thursday to add $100 million for women’s health services to the Senate’s budget proposal.

The recommendation was adopted by a working group of senators who serve on the Senate Finance Committee. Nelson heads the working group.

“It’s time for us to unite behind solutions we can all agree are in the best interest of keeping Texas women healthy. I believe in the power of prevention, and our plan will ensure that Texas women have access to the best possible preventive services such as cancer screenings,” Nelson said in a statement.

She also said the state must expand its provider network, provide more access for women in rural areas of the state and “recognize that family planning is a critical component of our efforts to support the health of Texas women.”

Nelson said the Senate’s starting-point two-year budget contains about $114 million for women’s health. Her workgroup proposed adding $100 million for women’s health through the Community Primary Services Program.

That program is different from the family planning program, whose funding was slashed by about $73 million, or two-thirds, two years ago by the GOP-dominated Legislature.

We are also aware of a bipartisan legislative group that is rethinking those family planning cuts. Before anyone dislocates a shoulder patting themselves on the back, however, I’d like to point out that some things, once broken, can’t be fixed.

Now, seven months later, the clinics remain closed. Shaw, who still runs other programs at Hill Country Community Action, recently told me that only 110 clients have called the agency for directions to other providers. The receptionist refers patients to Round Rock or Waco. When I called those providers, I was surprised to find that they could offer me next-day appointments. Though 98 percent of Hill Country Community Action’s clients had received well-woman care for free, this is not the case at other clinics. No longer able to participate in the Women’s Health Program for political reasons, Planned Parenthood in Waco must now charge patients for care. A well-woman exam, for example, costs $99. Women’s Health Program clients can be seen for free in San Saba at a local Scott & White provider, but that clinic charges full-fee to those who don’t qualify: women under 18 or over 44 or who can’t prove that they are legal citizens. An office visit at the Scott & White clinic would cost $83. Similarly, Lone Star Circle of Care in Round Rock provides services on a sliding fee scale based on income. None of their services are free.

It was more difficult to track where other displaced clients had gone. A Scott & White staffer told me by phone that she hadn’t seen an increase in new patients since Hill Country Community Action closed its clinics. Similarly Lone Star Circle of Care, via an email from director of communications Rebekah Haynes, said that the number of patients the Round Rock clinic had seen from San Saba was relatively small. The Planned Parenthood health center in Waco had seen a significant uptick. Danielle Wells, assistant director of communications for Planned Parenthood of Greater Texas, said by email that in 2012, the Waco health center had served 10 to 15 times as many patients from the zip codes once served by Hill Country Community Action as the year before. Clearly, some displaced patients have found new providers, but others haven’t. Time will tell what effect the closures will have on the reproductive health of those others, but public-health policy analysts are expecting an increase in unintended pregnancies and the number of births covered by Medicaid.

Texas’ new family-planning infrastructure is in flux. The Texas Legislature has three months left in its 83rd regular session, and advocates are lobbying for lawmakers to restore money while public-health specialists are scrambling to study the impact of the state’s defunding of family-planning clinics. In San Saba, even if funding is restored, it would be difficult to reopen the clinics. The staff has mostly moved on to other jobs. Gina Woodward now works for her family business, having hung up her stethoscope for good. After months at home, Melody Ball started a job in another field this month. Eva McDuff is still without work. I asked Tama Shaw if she might revive the family-planning program if funds are restored from the state or federal government. “It would take too much startup money, because the facilities are gone,” Shaw said. “We couldn’t start up again. Everything is gone.”

Those are the last three paragraphs in a story about a small community clinic in San Saba that had to close its doors after getting shafted by the 2011 Lege; see also this story from last year about other clinics around the state getting devastated. Some services will be restored in some places for some people, but sometimes you can’t un-ring the bell, or perhaps more appropriately, you can’t un-fertilize the egg. Everyone who voted for those cuts in 2011, no matter what they do this session, will forever have that stain on them.

The war on women continues apace

Honestly, I’m surprised that it’s taken as long as it has for this to happen.

Right there with them

Abortion clinics in Texas may soon face harsh new state requirements that pro-choice advocates say could greatly reduce access to abortion.

Sens Bob Deuell (R-Greenville), Donna Campbell (R-New Braunfels) and Charles Schwertner (R-Georgetown) filed a bill this morning that would require abortion clinics to meet the same conditions as ambulatory surgical centers.

The measure, Senate Bill 537, would force abortion clinics to follow the Texas Administrative Code for surgical centers, a 117 page document outlining everything from laboratory, nursing and anaesthesiologist requirements to radiological and construction procedures. Most of this code has little to do with the services provided by abortion clinics.

Filed by three pro-life doctors, legislation like this has been viewed as an underhanded tactic, which, in other states (like Alabama), has been criticized for threatening to close abortion clinics that don’t have the capacity or funding to meet such strict new requirements.

However, Sen. Deuell contends that the legislation is simply a method of increasing safety and health among Texas women. “Just as a medical doctor,” he said, “it came to me that they’re not under the same standards as any other surgical clinics and that we need to put them under that just for the safety of the patients.”

Deuell was adamant that the bill isn’t a pro-life tactic to close abortion clinics or make abortion less accessible. “It has nothing to do with abortions being done or not done.” He continued, “They’re legal, so they’re being done, and it is a surgical procedure, and it needs to be done in a place that has the same standards as a surgical center. Simple as that.”

He also asserted that the legislation would actually improve women’s health and accessibility to abortion providers. “The pro-choice movement talks about wanting to take abortions out of the back alley so they can be done properly. If you’re not certified as a surgical center, then that gets more toward the back alley and not in mainstream medicine, which is where it needs to be,” Deuell said.

Yes, I’m sure this just now came to Sen. Deuell. Of course, by his own reasoning, if he’s so concerned about women’s health, this should have been the very first bill he ever filed in the Senate. I mean, just think about all those poor women, having to get abortions in clinics that don’t measure up to his standards for cleanliness and safety for all these years. It’s scandalous, really. Of course, anyone who is content to let thousands of people die through his or her inaction or out of political spite really has no standing to claim “concern” for anyone’s health. The term “pro-life” is such a travesty these days, Jonathan Swift would be embarrassed to use it.

Not that any of that matters, I suppose. If this passes the Senate it will easily become law, and I have no reason to believe the courts will block it. As such, there are three people in the state that can prevent this from happening: Senators Eddie Lucio, Carlos Uresti, and Judith Zaffirini. It was their support of the awful sonogram bill that allowed it to clear the two-thirds bar in the Senate and make its way to Rick Perry’s desk. It took all three of them to enable its passage, since Jeff Wentworth stood with the other nine Democrats to hold this off. Depending on whether this abomination comes to the Senate floor before or after the SD06 special election is resolved, we may need two or all three of them to say no, this is going too far. This would be an excellent time to call their offices and make your voice heard, especially if you live in their district. It’s up to them to decide who they want to stand with.

Somewhat ironically, that news story cam out at the same time as this one.

Doctors, hospitals, clinics, health care groups, faith organizations and family planning associations urged lawmakers Wednesday to restore funding cut from women’s health programs for contraceptives and health screening.

At the forefront of their fight are two women who serve on the House Appropriations Committee, Republican Rep. Sarah Davis, of West University Place, and Democratic Rep. Donna Howard, of Austin. Both appeared at a Capitol news conference hosted by the Texas Women’s Healthcare Coalition.

Howard cited state estimates that thousands more unplanned births to low-income women as a result of family planning cuts will cost Texas millions more in Medicaid payments.

The state has projected 6,480 more Medicaid births at a cost of $33 million in the current fiscal year due to the reduction in family planning expenses. In the next two-year budget period, an extra 24,000 births are anticipated at a cost of $103 million.

Davis, a breast cancer survivor who is on an Appropriations subcommittee overseeing health and human services, said, “It’s really no longer the time to be playing politics with women’s health.”

In the Statesman, Rep. Davis is quoted saying that some of her Republican colleagues who voted for the cuts “didn’t realize they would hurt other kinds of clinics”, which is a polite way of saying that they’re deeply ignorant. They were told at the time exactly what would happen, they just chose not to believe it. It’s nice to hear that they may be slightly less willfully dumb this time around, but their concern for women’s health remains at best highly selective.

Changes will be coming

Robert Miller has a look at who we know won’t be back in the Lege for 2013. It’s a list that’s sure to get longer – I’m aware of a few more rumored retirements, and there’s already numerous primary challenges out there. In some cases, the legislative shuffling is creating openings elsewhere – first term SBOE member Marsha Farney will not run for re-election so she can pursue HD20, which is open because one-term State Rep. Charles Schwertner is running for SD05, which has been left open by Sen. Steve Ogden’s retirement. The reverse may also be true – State Rep. Dwayne Bohac in HD138 is among the throng hoping for an appointment to Jerry Eversole’s seat on Commissioners Court. Whether he gets it or not, there’s a decent chance that a current State Rep in Harris County might try to win that seat in the primary anyway. And on and on.

What this means is that I believe we are going to have at least three elections in a row with a lot of changes. 2010 was the first, 2012 is already shaping up that way, and as I have noted before, one way or another we could have a situation where there are no incumbents running for re-election to statewide non-judicial offices in 2014. That’s before taking into effect the electoral toll that may be exacted from another slash-and-burn legislative session. It’s going to be a bumpy ride, and I won’t be surprised if it continues beyond that. PDiddie and EoW have more.