In a year when state lawmakers convened with the goal of cutting taxes and holding the line against federal health reform, Texas' Republican leadership in 2015 also sought to cut funding from Planned Parenthood and a therapy program for children with disabilities, bar Syrian refugees from resettling in the state, enact further abortion restrictions and reorganize the state's health care bureaucracy.
Here are the year’s top health and human services stories:
1. A renewed war with Planned Parenthood
Anti-abortion activists in 2015 released a series of undercover sting videos shot at Planned Parenthood clinics, including one filmed in Houston in April, purporting to show that the women’s health organization had improperly harvested aborted fetal tissue for researchers. The group has vehemently denied those claims. Gov. Greg Abbott and the state’s Republican leadership pounced on the videos, launching inquiries into Planned Parenthood and vowing to kick the women’s health provider out of the state Medicaid program. But that hasn’t happened yet, and state leaders have gone silent as to why.
2. Backlash over cuts to a therapy program for children with disabilities
Texas lawmakers cut $100 million in state funding — forfeiting roughly $150 million more in federal matching funds — by slashing payments to speech, physical and occupational therapists through Medicaid, the federal-state insurance program for the poor and disabled. Therapy providers and families of children with disabilities took the state to court, arguing the cuts would jeopardize medically necessary care. But fiscal conservatives, saying there was wiggle room in the Medicaid budget for cuts, wondered whether in-home therapy providers were taking home generous paychecks on the state's dime.
3. Texas’ restrictive abortion law headed to high court
The long story of Texas’ embattled abortion law, passed in 2013 and known as House Bill 2, began what could be its final chapter when the U.S. Supreme Court in November agreed to hear arguments in a case over the law’s constitutionality. The law requires Texas abortion facilities to meet hospital-like standards, including minimum sizes for rooms and doorways, pipelines for anesthesia and other modifications. Opponents of the law say those requirements could shut down about half of the state’s 19 remaining abortion clinics, which they argue would unduly burden some Texas women left to travel more than 150 miles to the nearest abortion facility. The high court could take up the case as early as March, with a decision expected in the summer.
4. Texas tried, failed to ban Syrian refugees
Following a terrorist attack by Islamic extremists in Paris that killed 130 people, Abbott announced that Texas would not cooperate with the federal government’s plan to resettle Syrian refugees. Texas Attorney General Ken Paxton then tried twice to block the refugees’ arrival. Those attempts have been unsuccessful but remain the center of fierce political debate over immigration and national security.
5. With hospital funds on the line, Republicans held firm against Medicaid expansion
The Obama administration warned Texas officials that billions of dollars in federal funding for hospitals could be in jeopardy if the state did not expand government-funded health coverage to low-income Texans. But Texas’ Republican leadership, led by Abbott, held firm in its opposition to expanding Medicaid coverage, which would be at least 90 percent financed by the federal government. Republicans have criticized Medicaid as an inefficient public program and objected to expanding its coverage to able-bodied adults. In the meantime, public hospitals that must treat high volumes of uninsured patients say they are left hurting without some kind of government action.
6. New telemedicine regulations sparked debate, lawsuit
The Texas Medical Board, which licenses and regulates doctors, adopted new regulations on telemedicine, the practice by which physicians make patient diagnoses and sometimes write prescriptions by phone or over the Internet. The new rules prohibit doctors from performing telemedicine unless they first have an established relationship with a patient, which in most cases requires an in-person visit. That conflicted with the business model of Dallas-based Teladoc, which connects remote doctors with patients around the country. The telemedicine giant in April filed suit against the medical board, and observers say the case could have far-ranging implications for the fast-changing industry.
7. Obamacare survived one major lawsuit, then Texas filed another
The U.S. Supreme Court in June upheld a key element of the president’s signature health law — the part that gives tax subsidies to people who buy health insurance on the Affordable Care Act’s federal marketplace. But five months later, in October, Paxton filed a lawsuit arguing that a fee states must hand over to help pay for the sweeping federal health reform law is unconstitutional.
8. Health agencies tapped for mega-merger
Three of the five agencies under the umbrella of the Texas Health and Human Services Commission, with a combined annual budget of about $34.5 billion and 54,000 employees, will merge into one under a law approved by state lawmakers this year. Advocates for low-income Texans originally expressed concern about the merger, but lawmakers determined the new organization would be a more efficient allocation of state resources. Though all five agencies were originally slated for merging, a series of contracting scandals at the commission persuaded lawmakers to leave a recommendation to consolidate the remaining two agencies — the Department of State Health Services and the Department of Family and Protective Services — to the next legislative session, in 2017.
9. Obamacare signups sought, scammed
With its perpetually high number of people without health insurance — and lagging behind other states in the rate of Obamacare signups — Texas found itself in the line of sight of federal officials seeking new people to enroll in subsidized health insurance under the Affordable Care Act. At the same time, nonprofit workers in the Rio Grande Valley say they’ve seen an increase this year in the number of ripoff artists charging Texans for help signing up for health insurance, a service they are eligible to get for free.
10. Foster children dropped from health coverage
Advocates alleged that Texas officials were routinely denying health care coverage to former foster children after they turn 21, even though federal law says the coverage should continue until they turn 26. The news came as child welfare supporters and state officials were awaiting a decision in a class-action lawsuit that could potentially reshape the Texas foster care system.