Texas Health Insurance Charts Own Path

In an effort to address skyrocketing Medicaid costs, Texas State Senator Jane Nelson filed legislation to allow Texas health insurance to chart its own path for health care policies and programs. The bill would authorize Texas to participate in a multi-state effort to secure the consent of Congress for those states to regulate health care free of federal influence, including the state’s Medicaid program, through funding called “block grants.” Interstate compacts are authorized by Article 1, Section 10 of the U.S. Constitution.

Senator Nelson also jointly filed Senate Concurrent Resolution 14, which asserts states’ rights under the 10th Amendment to the U.S. Constitution.
Senator Nelson also recently filed a bill that would establish the Texas Institute of Health Care Quality and Efficiency to improve health care and study methods of cost containment in the state, including provider collaboratives that closely resemble Accountable Care Organizations (ACOs). It would also require the Institute to study the feasibility and desirability of establishing an all-payer claims database (ACPD) and develop a plan to establish such a database. Since the bill was filed, multiple health plans, physicians, hospitals, and others have attended at least six rounds of negotiations on the bill in order to comply with the fast-track schedule set by the bill’s author. Aetna insurance national trade association also weighed in, expressing its concerns on the antitrust implications of ACOs or health care collaboratives, recommending considerations for developing an ACPD, and making recommendations for transparency of health-related data collected by the Institute. Senator Nelson has requested that all feedback on the bill be provided by March 18, 2011.

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