Advocates for the poor will tell you that one of their biggest complaints with the Medicaid system in Texas is the sign-up process. Texas is one of only 12 states that still require a face-to-face interview with a caseworker before someone can receive benefits. It's one of only five states that require both the interview and the so-called assets test that uses what someone owns in addition to their income level to determine whether they're eligible for benefits. And the forms are complicated.
It would be relatively easy to change those things, but it could be quite expensive. An early estimate done for legislators said the changes could add well over $300 million to the annual cost of Medicaid in Texas. That's on top of a Medicaid budget that's already hip-deep in red ink because of incorrect guesses about rising costs and caseloads two years ago.
This arises now for several reasons. Democrats, here and nationally, are hitting Gov. George W. Bush's "compassionate conservatism" with the contention that the state's assistance programs are skimpy. Add these: The legislative session is approaching, the state is appealing a federal ruling that it didn't keep its promises for certain children's benefits, and the successful marketing of the Children's Health Insurance Program, or CHIP, is highlighting some problems with Medicaid in Texas.
CHIP started this year in Texas. It is meant to provide insurance to kids whose families aren't well off, but who don't qualify for Medicaid. The state's share, in Texas' case, is paid out of proceeds of the tobacco lawsuit settlement, and the federal government pays in almost three bucks for every dollar the state spends. The feds include two catches that are pertinent here: They require aggressive marketing to let people know about the program, and they require the state to sign up Medicaid-eligible people who show up because of the CHIP ads. If you apply for CHIP, but turn out to be eligible for Medicaid, the state is obliged to put you on Medicaid. That's called spillover.
The Spill-Resistant CHIP Cup
Texas has enrolled 94,700 kids for CHIP since the program got going earlier this year. Another 41,060 appear to be eligible and are somewhere in the queue between application and enrollment. That's one of the fastest initial enrollment rates in the U.S. and means Texas has already signed up -- in just a couple of months -- nearly a third of the kids it expects to have in CHIP two years hence.
But Medicaid spillover numbers aren't keeping up. According to the Texas Health and Human Services Commission, 58,783 kids who applied for CHIP appear, at first blush, to be eligible for Medicaid. Of those, 35,377 have been referred to DHS, where they can sign up for benefits, and the rest are waiting to see whether family assets put them in the Medicaid or the CHIP column. In spite of the heightened demand, only 4,767 of those kids had actually been signed up to receive Medicaid benefits by the beginning of this month, according to the commission.
Advocacy groups estimate there are more than 550,000 children eligible for Medicaid in Texas who aren't signed up for it. Budgeteers assumed the CHIP spillover would add some 34,000 new Medicaid recipients. They and some legislators say that's because of barriers both to entry and to continued participation, including complicated enrollment forms, asset tests for potential recipients, the state's requirement for face-to-face interviews, and the fact that Texas knocks people out of the program when their incomes go above the limits instead of automatically signing them up for 12 months when they qualify. The Texas CHIP Coalition -- an assembly of do-gooders, trade associations and others -- is asking lawmakers and the health and human service agencies to change all that.
Tinkering or Remodeling
Last spring, the Legislative Budget Office estimated it would cost up to $596 million to make changes pushed by groups like the CHIP Coalition. The numbers are soft and had the effect of bolstering opponents to change, who can rally behind high costs, and angering advocates of change, who say the estimate was way wide of the mark. The number-crunchers will have tighter estimates later, but budget estimates on health and human services are notoriously flaky and don't always sway the arguments between the forces on the left and right.
Don't expect anything historic this year, but the arguments will carry into next year's session.
Some small changes are afoot now. In addition to interviews when people initially sign up for Medicaid, Texas requires periodic face-to-face interviews of people who want to stay in the program. By the time you read this, the Department of Human Services board probably will have voted to allow recertification interviews on the telephone. The advocates are glad to see it, but say the initial interviews -- not the later ones -- are the real barrier to entry into the benefit program.
You have to leave town to fix blame for complicated enrollment forms. State officials and advocate groups came up with new forms for Medicaid enrollment that are twice as long as the current forms but easier to figure out. They want to test them in a couple of counties before going statewide, but can't do anything until the powers that be in Washington approve. That's pending.
And one last thing: Within the next few days, some of the people who want to rework some of the state's Medicaid rules will release a report spelling out their suggestions. That was ready to go several days ago, but the sponsors ducked when the issue came up in the presidential campaign because they didn't want their efforts interpreted as election politics.
Yet Another Succession Rumor Debunked
We heard about a random inquiry on the subject of redistricting and the lieutenant governor's race, so we made a couple of calls to legal beagles we know.
The question: If Gov. George W. Bush wins in November, and Lt. Gov. Rick Perry moves into the Governor's Mansion, what happens to the Legislative Redistricting Board? This one was apparently cooked up in a gathering of Republicans in some smoke-free backroom, and the premise was that it would cut the number of voters on the LRB to four.
Not so, say the lawyers who'll tell us this stuff for free. Perry would move up and lose his place on the LRB, sure enough. And the Senate would elect one of its own to replace Perry but without actually getting the title of Lite Guv. But title or not, the Texas Constitution says that senator, or presiding officer, would perform the duties of the Lite Guv. That means he/she would serve on the LRB just like a regular ol' lieutenant governor. More to the point, it means a presiding officer/senator would wield all the deal-making making power that goes to anyone in that corner office, especially handy if the officeholder wanted to win election outright two years from now.
A Tale that Began the Last Time Texas Boomed Like This
Pending: The application for a presidential pardon filed by former Austin banker and political player Ruben Johnson in February 1999. Johnson was a regular among big Democratic contributors in Texas in the early 1980s, but was convicted in 1989 on federal bank fraud charges and served time in prison. In 1997, then-Land Commissioner Garry Mauro hired him and took a great deal of grief for it; later that year, a federal judge slapped down Johnson's plea to reduce the $4.6 million restitution he was ordered to pay when he was convicted eight years earlier. Now, friends of the banker are pushing for action on his pardon application before President Bill Clinton, an old chum of Mauro's, leaves office. The U.S. Department of Justice won't say whether the case is moving -- just that they have the application and that no action has been taken. Among those advocating a pardon are Lady Bird Johnson -- no relation to Ruben -- and retired newscaster Walter Cronkite. Mauro told the Dallas Morning News he hasn't talked to Clinton and won't do anything before the elections.
Bidness and Medicine Agree on Most Races
For all their differences of late, the Texas Medical Association and the Texas Association of Business and Chambers of Commerce agree on a lot of races for Congress and the Legislature. To the extent that they show any tendencies at all, the doctors' group tends to shy away from candidates on the right and the business group tends to shy away from candidates on the left.
TABCC kicked out all of their endorsements for the November elections, while TMA left some pending for later action. Both groups went with U.S. Rep. Pete Sessions, R-Dallas, over Regina Montoya Coggins in CD-5. And in the other congressional race that's considered a national target, both groups ducked, picking no favorite between U.S. Rep. Ron Paul, R-Surfside, and Democrat Loy Sneary. Paul is a doctor, but TMA will remain neutral anyhow. The business group is staying out of 14 Texas congressional races, including 13 held by Democrats. The doctors are officially neutral in CD-19, held by U.S. Rep. Larry Combest, and have left five races -- each with a GOP incumbent -- pending.
Both groups are backing Sen. David Cain, D-Dallas, in SD-2, and Rep. Todd Staples, R-Palestine, in SD-3, two races on everyone's radar. Cain is up for reelection; Staples is running for the only open Senate seat. The doctors got some internal flak for endorsing Cain, but they picked him before Dr. Robert Deuell got into the race. Cain's endorsement by business will make it harder for the Republican to get traction in that race, which has been touted by some in the GOP this year.
The business group skipped three Texas Senate races, each involving a Democratic incumbent, and followed that same pattern in the Texas House, skipping 49 of the 150 races. Some of those are uncontested reelection bids, but Democrats hold each of the 49 seats TABCC hopscotched. The docs stuck with their "friendly incumbent" rule in the Senate. In the House, they left eight races "pending", and decided to stay neutral in two races that are quite competitive.
The contested races TABCC is avoiding include: HD-5, where Rep. Bob Glaze is being challenged by former Rep. Bill Hollowell; HD-18, where freshman Rep. Dan Ellis, D-Livingston, faces Republican Ben Bius; HD-20, where Rep. Zeb Zbranek, D-Winnie, faces a rematch with Eddie Shauberger; HD-23, where Rep. Patricia Gray, D-Galveston, is opposed by Republican Jeff Harrison; and HD-138, where Rep. Ken Yarbrough, D-Houston, is being challenged again by Victoria Frayser.
The doctors group is sticking with the incumbent in each of those races.
TABCC endorsed Reps. Betty Brown in HD-4 and Wayne Christian in HD-9, both of whom are fighting off Democrats; banker Paul Woodard, a Republican, over pharmacist Chuck Hopson, a Democrat, in the HD-11 seat Staples is leaving open; Rep. Allan Ritter, a freshman in HD-21 who's opposed by Republican activist Mary Jane Avery; Rep. Robby Cook, in HD-28, whose opponent is a well-known accountant and baseball scout named Phil Stephenson; Jill Warren, a Republican trying to win an open seat over Democrat Ann Kitchen in the historically hostile environs of Austin; and Reps. David Lengefeld, HD-59 and Bob Turner, HD-73, two Central Texas Democrats who occupy top spots on the GOP's list of targets. They face Republicans Steve Fryar and Sid Miller, respectively.
TMA will remain neutral in the two open seat contests -- HD-11 and HD-48 -- saying their members are split. In the first race, the trade group's political action committee endorsed both candidates in the primary; they figure any result is a win at this point. The doctors haven't weighed in on Brown's race, but probably will, and they agree with TABCC on Christian, Ritter, Cook, Lengefeld and Turner, all of whom are in highly competitive races for reelection. TMA put a number of incumbents on ice, mostly Republicans, mostly for voting against a couple of bills TMA was pushing last session. Still pending: Reps. Rick Green, HD-46; Suzanna Gratia Hupp, HD-54; David Farabee, HD-69; Carl Isett, HD-84; Ray Allen, HD-106; Kenn George, HD-108; and Joe Driver, HD-113. Farabee is the only Democrat in the bunch. Green, Hupp and Allen all have opponents in November.
There's a pattern, more or less: Both groups mostly stuck with incumbents, especially in close races. Neither jumped in to actively oppose an incumbent -- that's the friendly incumbent rule at work -- but both groups snubbed some incumbents by withholding endorsements.
Another Tale from the Last Boom
Twenty years ago, Democrat Ann Kitchen worked for the Internal Revenue Service in Los Angeles, Austin, and Seattle, doing everything from data entry work to revenue work, where she worked on payment arrangements with taxpayers who owed money. She did that for a couple of years, then went to law school, worked in government and the private sector, etc., etc., until she decided last year to run for an open seat in the Texas House of Representatives.
Fifteen or sixteen years ago, Mark Yznaga took over a restaurant called the Common Market in Austin. The bust hit, and he went out of business. He ended up with a slew of tax liabilities, including over $54,000 in unpaid federal payroll taxes, almost $1,400 in unpaid personal income taxes, and more than $20,000 in unpaid state and local sales taxes.
In 1994, the two got married. Yznaga paid off the tax bills he knew about -- that would be everything but the sales taxes -- by 1998. The two bought a house last year and nothing showed up on their credit check, Kitchen said. Nothing showed up even when she hired someone to find out what was out there in the official record that might be used against her in her bid for a House seat.
But early this year, the two found out about sales tax liens that were filed starting in 1986 and ending in 1989, and they paid those remaining bills this year. The comptroller's office says liens were filed when the taxes went unpaid, the matter was handed over to the Attorney General, which sued and got a judgment. Yznaga paid the taxes, penalties and interest in mid-March of this year, right around the time of the Democratic primaries. The issue never came up in that race.
There are no records to show that any of his preexisting tax liabilities became his wife's problem, and Kitchen, an Austin lawyer, says the unpaid taxes weren't hers. She says the business went under before she and Yznaga were married and that the debts never became community property. She says she's proud her husband paid the debts even though it took a long time. She's also irked that old taxes she says she personally didn't owe have become a campaign issue. Kitchen is running against Republican Jill Warren, also an Austin lawyer, in HD-48, an open seat. Her take: "This is just a nasty way to get at me through my husband." There was no immediate comment from the other side.
Political Briefs and Tidbits
Lt. Gov. Rick Perry and his staff are busy with a background check. Michael Domecq, former president of a company called Allied Domecq, has been indicted on charges of money laundering and mail fraud, according to the Associated Press. The wire service says he and other executives are accused of diverting $14 million from the company into offshore accounts.
The Texas tie? Allied Domecq Spirits and Wine USA PAC was a sponsor of a Perry fundraiser this month. An aide says it was news to them, and they're looking into it. The last contribution from that PAC to Perry was in March for $4,000, even though the group was listed on the September invites.
• San Antonio businessman Dr. James Leininger is among the honorees for a "Heroes for Children" award granted by the State Board of Education. Those are awarded twice a year (each of the 15 board members names an honoree) and generally, but not always, go to people who volunteer in local public schools. Leininger was nominated by Rep. John Shields, R-San Antonio and then selected by Dr. Bob Offutt, the outgoing SBOE member from San Antonio.
Leininger is among the people behind the CEO Foundation, a privately funded program that pays for scholarships that allow low-income public school children in the local Edgewood ISD to go to private schools instead. He's also a co-founder of a similar national group called CEO America. The Texas Freedom Network, which opposes vouchers and voucher-like programs, planned to try to show up at the awards ceremony to give Leininger a "Zeroes for Children" award.
Home is Where You Park
Almost 9,000 voters in Polk County nearly got knocked off the list of registered voters before the state stepped in, and now we're guaranteed some court hearings, a lesson in what constitutes residency and a couple of weeks of back and forth in one or two East Texas political races.
This started a week or so ago, when seven voters presented papers to Marion "Bid" Smith, the county's tax assessor-collector, challenging the residency of nearly 9,000 people who live from time to time in the Escapees RV Park near Livingston. Those voters declare Polk County as their home, but spend much of their time driving around the country visiting other places.
Smith turned down the petitions, but three of the voters came back the next week with papers that fixed his objections. With those in hand, he started mailing notices to the voters in question, telling them to return an enclosed form if they still lived in Polk County.
Word traveled fast. Smith says about a third of those voters stop when the ballot changes from federal to state and local, but said the rest are strongly Republican. Local Republicans called the Texas Secretary of State's office. Officials there conferred with the Attorney General, then called Smith to tell him to stop sending notices until they'd had time to work out the legal details and get a court hearing on the petitions. Smith had sent about 1,000 of the notices at that point, and at our deadline was trying to figure out whether he or someone else would have to send "Never mind" notices behind them.
Smith says he thought he had the grounds to go ahead, and nobody in official Austin disagreed outright with that. Election officials said they just want to be sure they're right before they knock that many people off the voter lists.
Here's the political piece. Sen. Drew Nixon, R-Carthage, won election in 1996 by a 637-vote margin. In Polk County, he lost, but only by 217 votes. Pull a bunch of Republicans off the list and GOP contenders this year could have trouble on their hands. Ben Bius of Huntsville is challenging Rep. Dan Ellis, D-Livingston, and Rep. Todd Staples, R-Palestine, is trying to win Nixon's open Senate seat in a race with Democrat David Fisher of Silsbee. Those two are most interested in keeping the RV-ers on the rolls and the folks close to them protested loudly when the challenges came to light.
The Staples campaign directly blamed Fisher, contending that he and his law firm coached the voters who made the challenge in the first place. Fisher, through a spokesman, said neither he nor the firm had anything to do with it, and said they didn't even know about the issue until reporters called.
Separately, the Staples campaign started a run of television and radio ads pushing his "38-point-plan" for what he'll do if he's elected. They didn't intend to do that before October, but Fisher went up a couple of weeks ago and the Staples camp didn't want to stay in the dark.
Fisher, meantime, is shooting at Staples for claiming he led the fight against "chunking" in the prisons when he wasn't even a co-sponsor of the legislation. Chunking is the delicate description of inmates throwing, um, stuff at prison guards. The guards don't like it, but they like the legislation that cracks down on inmates for it.
Miscellaneous News-like Objects
U.S. Sen. Kay Bailey Hutchison picked Houston lawyer and UT Regent Pat Oxford to chair her reelection campaign. Waiting until this late in the game should clue you to the level of worry here: She faces Democrat Gene Kelly, who never danced professionally as far as we know, in November. Hutchison named Railroad Commissioners Michael Williams and Tony Garza to co-chair.
• The Battleground polls that came out during the Republican and Democratic national conventions are going daily through the elections. You can get a daily fix on the George and Al and Dick and Joe show at this Internet location: www.tarrance.com.
• The fifth annual Capital Ornament is out and you can buy it at the gift shop in the Pink Building or on the Internet at TexasCapitolGiftshop.com. This is the fifth year of ornaments and money from this Nelda Laney project goes to preservation of the Capitol. They're still making the first four ornaments if you want the whole set. They're $16 each, with quantity discounts.
Political People and Their Moves
After five months at the Texas Department of Economic Development, Nancy Fisher has left that agency to lobby for the Texas Association of Builders. TDED, up for sunset review by the Legislature next year, is still talking to replacement candidates... Karen Kenney Reagan is leaving the Texas Pharmacy Association for the Texas Retailers Association, where she'll spend a fair amount of her time with the Texas Federation of Drug Stores, a subset of TRA. The pharmacists are still interviewing potential replacements... Mary Jane Wardlow, who worked at the comptroller's office when Bob Bullock was the occupant of the big office on the first floor, is going back. Wardlow, who's been with the General Land Office working for David Dewhurst since he was elected, will join Carole Keeton Rylander's press shop. That's headed by Mark Sanders, an earlier Dewhurst expat... Attorney General John Cornyn raided the Florida Department of Juvenile Justice to hire Rex Uberman, who's moving here to head the crime victim services operation at the AG's office. Uberman, a Texas native, used to teach at Sam Houston State University in Huntsville and worked for the Dallas County Probation Department... Tom Kleinworth, director of state relations at Baylor College of Medicine in Houston, herniated a disk in his back. They operated. He's fine, but will be out for a month... Appointments: Gov. Bush picked Debra Lehrman of Colleyville to the 360th Judicial District Court, replacing resigning Judge Sue Koenig of Fort Worth. Lehrman is an associate judge in that court... Bush named Carlos Lopez of Irving to the 116th Judicial District Court, replacing Martin Richter of DeSoto. He had to do that because he appointed Richter to the 5th Court of Appeals in Dallas. Lopez had been a Dallas County Court at Law judge... Dale Miller, an electrical training director and a member of IBEW from Silsbee, got an appointment to the Texas Skill Standards Board. Bush's early appointments to the board irritated labor because some appointees had been managers and weren't union members.
Quotes of the Week
Democratic National Committee spokesperson Jenny Backus, teeing off on a Dallas Morning News report that Richard Cheney, the second-half of the GOP ticket, hasn't voted in 14 of the last 16 elections, including the March primary, when George W. Bush was on the ballot: "If Cheney didn't vote for Bush, why should the rest of America?"
Cheney, talking to a group in Michigan about reporters, in response to a question from the audience about the biases of the media: "Hopefully because the voters are reasonably intelligent... they'll be able to sort through some of that fog that sometimes passes for news coverage."
From a 1995 memo detailing talking points for Donald Fowler, then-chairman of the Democratic National Committee, to use in a phone call to Walter Umphrey, the prominent Texas trial lawyer: "I know" you "will give $100K when the president vetoes tort reform, but we really need it now. Please send ASAP if possible." Asked by The New York Times about the phone call a few days ago, Fowler said: "I'm sure I never said anything like that to him or anybody else. It's unwise."
Rep. Fred Hill, R-Richardson, reflecting on his five attempts to outlaw drinking while driving in Texas: "We have an element in the Legislature that thinks it is an inalienable right of a Texan to drink a beer on the way home from work and throw the empty in the back of a pickup truck."
U.S. Judge James Nowlin of Austin, writing to federal officials on whether former banker Ruben Johnson -- convicted in Nowlin's court -- should be pardoned: "If misapplication of funds by a bank officer who happens to have been active in his political contributions and activities is considered acceptable conduct by the executive branch then perhaps a pardon should be granted."
Lois Loden, who won $34.1 million in the Texas Lottery with her companion, Sharpstown scandal figure and former Texas Insurance Commissioner John Osorio, on whether they'll continue to work: "Absolutely not."
Louisiana Political Hall of Fame Director Carolyn Phillips, on the criminal conviction of former Gov. Edwin Edwards and how that fits with all of the honors he's received and all of the plaques, memorials and awards touting him: "We have a famous saying: 'We induct 'em, they indict 'em.'"
Texas Weekly: Volume 17, Issue 12, 18 September 2000. Ross Ramsey, Editor. George Phenix, Publisher. Copyright 2000 by Printing Production Systems, Inc. All Rights Reserved. Reproduction in whole or in part without written permission from the publisher is prohibited. One-year online subscription: $250. For information about your subscription, call (800) 611-4980 or email firstname.lastname@example.org. For news, email email@example.com, or call (512) 288-6598.
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