PUBLIC BENEFITS

Associate Director Anne Dunkelberg on the approval of the “Texas Healthcare Transformation and Quality Improvement” Medicaid 1115 Waiver. (Note: This waiver is different from the waiver to block grant Medicaid, which the Health and Human Services Commission has not yet submitted and about which the Center has grave concerns.)

The health of our entire state is improved when every one of us has access to quality, affordable health care. A key new consumer protection from the national health reform law will make it easier for Texans to purchase health care plans that provide better value for our money. Insurers are now required to meet minimum standards for how much of each premium dollar is used for health care, and to make rebates to consumers if they miss those standards. A recent request from the Texas Department of Insurance (TDI) seeks to delay full implementation of this new consumer protection, which will redirect to insurance companies hundreds of millions of dollars in rebates due by law to Texas consumers.

(AUSTIN, Texas) - On Monday, Federal officials finalized an application from the Texas Department of Insurance (TDI) to delay full implementation of a new rule that requires insurers to increase the value of health insurance or provide rebates to policyholders. If approved, Texans who buy insurance on their own outside of the protection of an employer could lose $350 in forthcoming rebates on average.

The Better Texas film. Together we can make our state a better place for all of us. A place of opportunity and prosperity. Because we all do better when we all do better.

The U.S. Senate and House Agriculture Committees have recommended a $4 billion cut to the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps) over the next 10 years as part of the deficit reduction plan being developed in Congress. A cut of this magnitude would harm thousands of low-income Texas families who struggle to put food on the table. It would also harm the food industry, Texas agriculture, food retailers and cost jobs. Our state and local economies receive an enormous boost from SNAP spending, particularly during a recession. Last year, 3.6 million Texans received SNAP assistance, pouring over $5 billion into the economy and generating a total of $9.1 billion in overall economic activity. Low-income Texans should not be asked to bear the burden of budget cuts. Congress has smarter and fairer ways at its disposal to balance the budget and resolve our long-term deficit problem, through a balanced package of selected tax increases and careful spending cuts.

CPPP submitted comments on several proposed federal rules that implement pieces of the Affordable Care Act related to Medicaid, Exchanges, premium tax credit eligibility and enrollment, and uniform summaries of insurance benefits. Taken together, these rules outline a sweeping vision for consumer-friendly tools and processes to help people understand and enroll in affordable coverage through Medicaid, CHIP, and the Exchange.

Executive Director F. Scott McCown regarding what should be done by the Joint Select Committee on Deficit Reduction (the “supercommittee”). The Budget Control Act requires the committee to propose by October 14 a way to reduce the federal deficit by $1.2 to $1.5 trillion over the next 10 years.

“For the good of the country, the committee needs to succeed. But success requires a balanced package that combines selected revenue increases with careful spending cuts. A cuts-only approach would devastate low- and moderate-income Americans because it would mean severe cuts in critical areas like Medicare, Medicaid, and Social Security.

“Our state would be among those hit hardest by a cuts-only approach because we have so many low-income families. Doing nothing would also be hard on Texas because it would trigger automatic cuts, including to defense. Texas benefits from significant federal spending, including from military bases and defense contracting. Most important, though, is that doing nothing would leave the country with an unsustainable imbalance between revenue and spending."

Temporary Assistance for Needy Families (TANF) is an important federal program designed to help needy families achieve self-sufficiency.

Nearly 4.4 million Texans live in poverty. At 17.9 percent, Texas’ poverty rate is the 8th highest among the 50 states. Children in Texas are hit particularly hard: 25.7 percent, or more than one out of four children, are living below the poverty line.

While TANF caseloads are projected to increase 7.6 percent from state fiscal year 2011 to 2013, federal funding for TANF remains stagnant and threatens to decrease.

American Community Survey

• The Texas Top 10 (PDF)
• ACS Tables: Metro Area Poverty and Uninsured (xls)

New data from the Census Bureau’s 2010 American Community Survey (ACS)¹ illustrates that poverty and uninsured rates vary dramatically by age, race and ethnicity, and across Texas’ metropolitan areas. Our analyses of the ACS data, released September 22, focus on 10 of the most striking findings.

The September 13 data released by the U.S. Census Bureau’s Current Population Survey shows that in 2010, Texas remained the state with the highest uninsured rate in the nation at 24.6 percent. The total number of uninsured Texans is 6.2 million people, roughly 250,000 fewer than in 2009.

Children continued to lose coverage through their parents’ job-based insurance. A significant positive note for Texas was the decline for a second consecutive year in the number and percent of uninsured children. This improvement is largely due to more children signing up for Medicaid and CHIP’s public insurance (which more than made up for the loss in job-based coverage), showing the essential role of these programs in protecting children during economic hard times.

Get the full story in the links below.

The U.S. Department of Agriculture (USDA) released its annual report that illustrates the struggle low-income Texans face in affording a consistent and nutritious diet. The USDA report, Household Food Security in the United States in 2010, reveals that almost one in five Texas households (18.8 percent, or 1.7 million households) were food insecure between 2008 and 2010, compared to 14.6 percent of households nationwide. Over one-third of these households (6.9 percent) are classified as having very low food security�"the more severe condition associated with food insecurity�"compared to 5.6 percent of U.S. households. Texas ranks second in the nation for the highest percentage of food insecure households, and is tied for third in the share of households experiencing very low food security.

The 82nd Legislature’s state budget for 2012-13 includes Medicaid-CHIP provisions with a mix of specific direct cuts and spending reductions totaling $2.03 billion general revenue (GR: state dollars) including $805 million GR in cuts to fees paid to Medicaid service providers; other benefit and spending cuts totaling about $843 million GR; managed care expansion savings of nearly $386 million GR; and roughly $4.8 billion GR in under-funding�"an IOU that will come due early in 2013. This Policy Page summarizes high-level Medicaid-CHIP decisions adopted for health and human services agencies; key funding developments for non-Medicaid health programs will be featured in an upcoming August analysis.

CPPP submitted comments to the U.S. Department of Health and Human Services (HHS) urging HHS to protect health insurance consumers by broadly applying rate review and disclosure provisions from the Affordable Care Act. Rate review is an important tool for expanding health insurance coverage by controlling costs. HHS requested comments on whether health insurance sold through “association health plans” should be treated like other insurance sold to individuals and small businesses, and subject to new rate review protections.

Federal and state high-risk pools provide key coverage options for Texans

The health of our whole state is ensured when all of us have access to quality, affordable health care-when we can count on the preventative care we need to stay healthy and see a doctor when we are sick. For many of us with pre-existing medical conditions, we can only get coverage through a high-risk pool. The Pre-existing Condition Insurance Plan (PCIP) is a federally administered high-risk pool created by the Affordable Care Act. Recently, the federal government announced changes that will help increase access to this coverage�"premiums in Texas were reduced by 24 percent and applicants can now prove they have a pre-existing condition by providing a letter from a health care professional, instead of waiting to receive a rejection letter from an insurance company. PCIP is one of two high-risk pools that provide coverage options for Texans.

Over 4 million Texans�"3 million children and 1 million seniors, adults with disabilities, expectant mothers, and very poor parents�"rely on Medicaid or CHIP for the critical health care and community supports they need.

Now, Medicaid and CHIP are targeted for extreme cuts in Austin and Washington.

Under the Patient Protection and Affordable Care Act (ACA), health insurers must spend a reasonable share of premium dollars on medical care and quality improvement efforts, as opposed to administration, marketing, and profits. These standards, known as medical loss ratio (MLR) requirements, hold insurers accountable for how they use consumers’ premium dollars.

Today, U.S. Department of Agriculture Secretary Tom Vilsack awarded performance bonuses to the states with the best payment accuracy rates in the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps) in fiscal 2010. The Texas Health and Human Services Commission (HHSC) earned $6.2 million in payment incentives for its performance in two categories: best payment accuracy and most improved payment accuracy. Center for Public Policy Priorities (CPPP) Senior Policy Analyst Celia Cole released the following statement.

“CPPP applauds HHSC Executive Commissioner Tom Suehs for his leadership, and HHSC’s frontline staff for their hard work in achieving this recognition. At 97.87 percent, Texas’ payment accuracy rate was above the national average of 96.19 percent. (Payment accuracy is measured by the amount of benefits issued accurately as a share of total benefits issued.) And at 4.77 percent, Texas’ tops the nation in most improved accuracy rate."

On June 7 the Governor added to the call for the special session: “Legislation relating to the use of the federal Secure Communities Program by law enforcement agencies, the issuance of driver's licenses and personal identification certificates, and the abolishment of sanctuary cities in Texas.”

Last year, we released Common-Sense Principles for Immigration Reform, which is a useful starting point to considering these issues. In that paper, we concluded: “To maintain national security, we must be able to control our borders. To grow our economy, we must welcome immigrants who want to work and who have the skills we need. And, we must enforce our laws in a way that honors American traditions and constitutional principles. We can do all this through a common-sense, fact-based approach to immigration reform.”

As the Legislature considers any legislation in response to the Governor’s call, we urge a common-sense, fact-based approach that recognizes the important role immigrants play to our economic vitality and is consistent with who we are as Americans.

CPPP testified in opposition to House Bill (HB) 5 of the first called Session. HB 5 would allow Texas to ask Congress’ permission to convert all federal health spending for Texas into a block grant based on 2010 levels. Medicare, Medicaid, CHIP, and all public and mental health block grants would be included; only military, veterans, and Indian Health funding would be excluded. As proposed, Texas could choose to eliminate any current federal standards for these programs (including who cover). The House Committee on State Sovereignty approved the bill for a vote by the full House.

April and May 2011 tracking polls from the Kaiser Foundation find most Americans oppose the idea of converting Medicaid to block grant financing to reduce the federal deficit, and the public remains opposed to major Medicare spending cuts as a way to reduce the federal deficit.

CPPP testified in favor of Senate Bill (SB) 7 of the first called Session. SB 7 includes elements from the 82nd Regular Session’s SB 23, SB 7, House Bill (HB) 32, HB 3537, and SB 8, plus some additional provisions. CPPP registered concerns about selected provisions of the bill, as well.

Major health care bills have been quickly re-filed in the 82nd Texas Legislature’s First Called (“special”) Session. Bills set for a hearing on Thursday, June 2�"the third day of the new session�"include a stand-alone proposal for Texas to ask Congress to turn Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), and all mental health and public health funding into a Block Grant to be run by Texas state government, and to end all federal minimum standards for who gets health care and how federal funds are used [Senate Bill (SB) 5 and House Bill (HB) 5]. Also set for hearing are nearly-identical large “omnibus” bills (SB 7 and HB 7) which set the stage for generally-positive health care payment and delivery reforms, with some troublesome provisions included.

With one or more U. S. House-passed, budget-cutting proposals expected on the Senate floor for debate this week, the Center for Public Policy Priorities (CPPP) and the Texas Food Bank Network (TFBN) say that the cuts proposed to the Supplemental Nutrition Assistance Program (SNAP, formerly known as Food Stamps) would weaken the program’s proven ability to help poor and hungry Texas kids and families.

Access to birth control for low-income Texas women will be critically wounded under the conference committee proposed budget, collateral damage in battles over abortion. Contraceptive services�"not abortion�"will be gutted in the state budget on two fronts. Like all states, Texas funds family planning through federal block grants and through Medicaid coverage. It should be noted that these programs provide not only birth control, but also preventive care and basic check-ups to low-income and largely uninsured women (one-third of Texas working age adults are uninsured). Sadly, the Texas legislature now proposes to profoundly undermine both areas of birth control access (again, not abortion services, which are not covered under either funding source, or funded in any way through our state budget). As proposed, these budget actions will cause over 400,000 Texas women to lose family planning and basic health services.

The conference committee on the state budget for 2012-13 adopted recommendations for nearly all health and human services issues on May 16. Medicaid provisions adopted include a mix of specific direct cuts and spending reductions totaling $1.65 billion general revenue (GR: state dollars) including $805 million GR in cuts to fees paid to Medicaid service providers; and a $4.8 billion GR under-funding or IOU that will come due early in 2013.

CPPP supports efforts to reduce obesity and encourage Texans to pursue a healthy diet. However, we are opposed to proposals currently being debated in the Texas Legislature [House Bill (HB) 1151 and HB 3451] and the United States Congress that would restrict the use of Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) benefits. These proposals have the potential to erode the value of SNAP benefits─already too little─and would weaken the programs proven ability to help the poorest and hungriest among us.

CPPP has teamed up with nine other consumer, patient, and faith-based organizations to voice our opposition to a group of bills in 2011 Legislature which fundamentally undermine or radically restructure Texas Medicaid and health reform.

The Texas House and Senate have adopted two different budget bills, and a conference committee has begun to work out a compromise budget.

Both chambers provide less money for Texas health and human services than was budgeted in 2010-2011. But the Senate’s version of the budget provides substantially more money for health care and social services than the House version.

Associate Director Anne Dunkelberg testified for Senate Bill (SB) 7 by Senator Jane Nelson.

As the 2011 Legislature winds down, time is running out for Texas to pursue its surest route to a state-based health insurance exchange. A health insurance exchange is a competitive marketplace where individuals and families can purchase private health insurance starting in 2014. Exchanges are established by the Affordable Care Act (ACA or federal health reform), which lets each state choose whether to design and run its own exchange, or turn the task over to the federal government. The ACA’s timeline gives states a limited window in which to pursue a state-based exchange before the federal government assumes the responsibility. Inaction this legislative session does not guarantee that Texas will ultimately have a federal health insurance exchange, but it certainly makes that outcome much more likely.

The 2011 Texas Legislature is considering a range of bills that would make major changes to Medicaid, from block granting the program along with Medicare and all other federal health funding, to using Medicaid as the laboratory for testing new models of care delivery and payments. Several bills, including the House and Senate budget bills, assume provisions to start charging some level of co-payments in Texas Medicaid. Given the current extreme revenue shortfall, the pressure to introduce co-payments is greater than ever before; for example, adoption of co-payments for visits to the emergency room that involve non-emergency medical care is considered likely. This Policy Page describes the Health and Human Services Commission’s (HHSC) proposals for Medicaid and the Children’s Health Insurance Program (CHIP) co-payments, the changes proposed in current bills, and the federal law and rules that Texas must comply with when imposing Medicaid and CHIP co-payments.

Associate Director Anne Dunkelberg testified against House Bill (HB) 5 by Rep. Lois Kolkhorst.

House Bill (HB) 2723 by Representative Walle ensures that people who buy health insurance in the individual market (directly from an insurer, not through an employer) will be sent notices of premium increase at least 60 days in advance. This mirrors the notice timeline for job-based health insurance, giving families sufficient time to either shop around for more affordable coverage, or adjust their budgets to be able to absorb the increase.

Senate Bill 1430 authorizes a new type of fully insured health benefit plan, an exclusive provider organization (EPO), that combines features from preferred provider organization (PPO) plans and health maintenance organizations (HMOs). EPOs have the potential to lower premiums, which can increase access to coverage for small employers and families. However, lower EPO premiums come with tradeoffs for consumers�"less access to out-of-network care than a PPO and higher and less predictable out-of-pocket costs (deductibles and coinsurance) than an HMO.

The House’s adopted budget and the Senate Finance Committee’s approved budget (the full Senate has not yet voted on this bill) take significantly different approaches to allocating and cutting funding for Texas Medicaid and CHIP. Still, one important approach used by both chambers is a substantial under-funding of the program overall that is not associated with particular policy changes or program cuts. Since Medicaid is an entitlement, an underlying assumption is that the state will keep paying Medicaid and CHIP health providers for services every month as long as there is money available, and can cover the “unassigned” budget cuts with a supplemental appropriations bill in the 2013 session as long as funds do not “run out” before January 2013.

The Center for Public Policy Priorities and Methodist Healthcare Ministries are pleased to release this updated primer, designed to give readers an introductory overview of factors shaping Texans' access to health care. Readers will be better able to contribute to federal, state, and local debates about how to improve health care access.

Senate Bill (SB) 1454, by Senator Eddie Lucio, Jr., and House Bill (HB) 2414, by Representative Boris Miles, seek to improve the nutritional health of Texans by exploring ways to increase access to healthy and affordable food.

The Affordable Care Act (federal health reform) creates new health insurance “exchanges” or marketplaces that will open in 2014. Each state will have an exchange, and will decide whether to design and run its own exchange, or turn that job over to the federal government.

If Texas chooses to set up and run its exchange, the state will have broad flexibility to design a health insurance marketplace that meets the needs of Texans. If Texas leaders do not act soon, the federal government will have the responsibility of designing Texas’ exchange. Whether decisions are ultimately made by the Texas Legislature or the Obama administration, Texas’ exchange should be designed to give Texas families and small businesses more control, high-quality choices, and better protections when buying health insurance.

The Center for Public Policy Priorities supports Senate Bill (SB) 1004, because it addresses two major challenges facing Texas: the need to fund a balanced approach to the 2012-13 budget, and the need to improve nutrition and curb obesity, which cost the state $9.5 billion in 2009. Imposing a tax on soft drinks could raise up to $4 billion over the biennium. Increasing the cost of soft drinks has been proven to discourage their consumption, which is associated with poor diet, high rates of obesity and risk for diabetes. Texas needs this additional revenue, along with dollars from the Rainy Day Fund, to minimize damaging cuts to public education, higher education, and health and human services.

House Bill 13 by House Public Health Committee Chairman Lois Kolkhorst would direct The Texas Health and Human Services Commissioner to seek a “waiver” of federal law to dramatically restructure the Texas Medicaid program. In laying out the Committee Substitute for her bill, Chairman Kolkhorst identified a recent Rhode Island “1115 waiver” as a model for what Texas might seek. CPPP testified in opposition to the bill. Our testimony details our objection to overly broad terms of the bill that do not give any guarantee of protections for current beneficiaries, covered populations and services. We detail a list of specific provisions which would prevent the concept from being workable in Texas without substantial additional changes to Texas law and protections for Medicaid’s vulnerable population of children, seniors, Texans with disabilities, and expectant mothers.

The Center for Public Policy Priorities (CPPP) released the following statement regarding U.S. House Budget Committee Chairman Paul Ryan’s budget resolution.

Texas Medicaid and the Children's Health Insurance Program (CHIP) provide vital health care and life-saving supports for some of our poorest and most vulnerable.

Medicaid funding in the House’s budget falls $5.8 billion in general revenue (GR) below what is needed to maintain the program benefits and populations (state dollars; $13.7 billion all funds). This is after the House added $1.8 billion in GR ($4.3 billion all funds).This is still six times the size of the painful cuts to Medicaid and the Children's Health Insurance Program (CHIP) made by the Legislature in 2003.

House Bill (HB) 643 would ensure more children in low-income neighborhoods have access to nutritious meals during the summer. This legislation by State Representative Eddie Rodriguez would increase the number of school districts subject to a state law requiring districts in low-income communities to operate the program. The Summer Food Program provides over $52 million in federal funds each year to low-income communities in Texas to help serve nutritious meals to children in safe, enriching environments. The Summer Food Program is critical in a state like Texas, where too many children are in poor nutritional health.

CPPP supports HB 3397, which would make felony drug ex-offenders eligible to receive federally funded food assistance and employment services through the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps). Enabling this population to receive SNAP services would help ex-offenders to rebuild their lives and reintegrate into our communities, thereby reducing recidivism and the state cost of reincarceration. This legislation comes at a critical time for Texas, as lawmakers are considering eliminating $21.2 million for Project Rio, one of the few sources of funding for reentry services.

The House Human Services Committee will hear HB 3397 on Tuesday, March 29. HB 3397, by Representative Alma Allen would make felony drug ex-offenders eligible to receive federally funded food assistance and employment services through the Supplemental Nutrition Assistance Program (SNAP, formerly Food Stamps). Enabling this population to receive SNAP services would help ex-offenders to rebuild their lives and reintegrate into our communities, thereby reducing recidivism and the state cost of reincarceration. This legislation comes at a critical time for Texas, as lawmakers are considering eliminating $21.2 million for Project Rio, one of the few sources of funding for reentry services.

When finger imaging was first implemented, the eligibility determination process for food stamps was paper-based. At that time, there was no way for the Health and Human Services Commission (HHSC) to electronically verify an applicant’s identify to prevent that person from applying for benefits more than once. HHSC has since deployed the TIERS system and introduced electronic third-party verification using sources such as Data Broker and other electronic interfaces. This technology provides HHSC with more cost-effective tools to verify applicant information and confirm identify.

Celia Cole provided testimony to the House Committee on Human Services on HB 710, explaining that the finger imaging requirement for food stamps both undermines HHSC’s efforts to develop more efficient eligibility and enrollment processes, and costs the state of Texas millions in crucial taxpayer dollars.

Opponents to national health care reform are proposing to use federal dollars to fund alternative interstate health care compacts that effectively Block Grant federal health care funding.

Texas Department of Insurance (TDI) and Office of Public Insurance Council (OPIC) are under “Sunset review” this session and must be reauthorized by the Legislature to continue. Both agencies are needed to protect Texas insurance consumers.

House Bill (HB) 1 and Senate Bill (SB) 1 under consideration today fall short of continuing all state services by at least $27 billion in state General Revenue (GR). The Legislative Budget Board (LBB) estimates Medicaid alone is short $7.6 billion GR�"$18 billion including the loss of federal-matching funds. This under-funding would be more than seven times the depth of the disastrous 2003 Medicaid and Children’s Health Insurance Program (CHIP) cuts.

The health insurance connector (or exchange) will play a critical role in expanding coverage to low- and moderate-income working Texas families. Under health reform, connectors must both create a consumer-friendly, competitive marketplace for purchasing health insurance and determine eligibility for and facilitate enrollment in exchange premium subsidies, Medicaid, and CHIP. House Bill 636 will establish a Texas health insurance connector. Decisions made by the Texas Legislature in designing a state-based connector will determine whether it can serve the best interest of Texas small businesses and families and enhance constructive competition.

The Affordable Care Act (commonly called federal health reform) creates new health insurance “exchanges” that will open in 2014. An exchange is a competitive marketplace for health insurance�"think of Travelocity for airplane tickets and Amazon for books�"that will give consumers more control, quality choices, and better protections when buying health insurance.

Medicaid funding proposed in HB l is estimated by the Legislative Budget Board (LBB) as falling $18 billion (All Funds) below the amount need to maintain current benefits, provider fees, and eligibility standards. This underfunding would be more than 7 times the depth of the disastrous 2003 Medicaid and CHIP cuts. While delivery reforms and best practices can and should be aggressively implemented, the best program improvements combined cannot achieve savings anywhere near the $7.6 billion GR shortfall. The Legislature should begin immediately looking for ways to mitigate the damage to our state’s most vulnerable through a balanced approach to balancing the budget that looks to savings and new revenues, not a cuts-only approach.

CPPP, La Fe Policy Research and Education Center, Texas Legal Services Center, and Texas Public Interest Research Group submitted comments to U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius in response to the notice of proposed rulemaking for Rate Increase and Disclosure Review. While the proposed rule gives consumers and regulators more information on proposed rates hikes, we urge HHS to strengthen the standards for effective state review to better protect consumers and help constrain the growth in health insurance rates.

The Texas eligibility system delivers over $25.7 billion in benefits annually, and more than 6.4 million needy Texans rely in these services. When our eligibility system fails, Texas loses out on billions of federal dollars that fuel our state and local economies�"particularly during a recession when unemployment has risen and consumer spending has dropped.

We need to provide adequate funding to support the Texas Health and Human Services Commission's eligibility system and DSHS WIC/Farmer's Market Nutrition services.

Medicaid funding proposed in HB l is estimated by the Legislative Budget Board (LBB) as falling $18 billion (All Funds) below the amount need to maintain current benefits, provider fees, and eligibility standards. This underfunding would be more than 7 times the depth of the disastrous 2003 Medicaid and CHIP cuts. While delivery reforms and best practices can and should be aggressively implemented, the best program improvements combined cannot achieve savings anywhere near the $7.6 billion GR shortfall. The Legislature should begin immediately looking for ways to mitigate the damage to our state’s most vulnerable through a balanced approach to balancing the budget that looks to savings and new revenues, not a cuts-only approach.

The Texas eligibility system delivers over $25.7 billion in benefits annually, and more than 6.4 million needy Texans rely in these services. When our eligibility system fails, Texas loses out on billions of federal dollars that fuel our state and local economies�"particularly during a recession when unemployment has risen and consumer spending has dropped.

We need to provide adequate funding to support the Texas Health and Human Services Commission's eligibility system and DSHS WIC/Farmer’s Market Nutrition services.

On January 13, CPPP Executive Director Scott McCown was invited by the Texas Public Policy Foundation to debate Ted Cruz, former Solicitor General of Texas, on federalism and the constitutionality of the Affordable Care Act. Scott explained why conservatives should support the Act and the advantages for Texas.

What do we want Texas to be? A state that won’t squander an opportunity to properly implement the new health reform law.

The new law changes the health care landscape in Texas. It is an important tool Texas can use to achieve our own health policy goals, such as increasing coverage, improving transparency and quality, and controlling costs.