McALLEN, RGV – The battle to establish healthcare districts in both Cameron and Hidalgo counties could develop into a Republicans v. Democrats issue, if an email from a local political activist is anything to go by.

Jim Barnes, a Republican Party stalwart and president of the McAllen/Hidalgo Tea Party, says various local Republican and Tea Party groups met Saturday to mobilize opposition to legislation being heard at the state Capitol that would allow voters to determine if a healthcare district should be set up in Cameron County.

Jim Barnes
Jim Barnes

Barnes and others did the same thing when similar legislation was being considered for a healthcare district in Hidalgo County. He said Republican House members Jonathan Stickland and Tony Tinderholt “pushed back hard against Bobby’s bill” after Tea Party and Republican Party activists called their Capitol offices in Austin.

The “Bobby,” Barnes was referring to is state Rep. R.D. ‘Bobby’ Guerra, D-McAllen, author of legislation that lowers the cap on how much tax money a healthcare district in Hidalgo County could levy. The Hidalgo County legislative delegation is all Democrat and the delegation is fully behind Guerra’s legislation.

The Cameron County legislative delegation is all Democrat. This delegation is set to unite behind Cameron County healthcare district legislation.

“A joint committee for a common cause met on April 11 to discuss Senate Bill 2034, filed by Senator Lucio, Jr., for a Cameron County Healthcare District. The bill is very similar to a bill Senator Lucio filed in February, Senate Bill 626, setting up a Hidalgo County Healthcare District,” Barnes wrote, in an email sent Saturday to Tea Party and Republican Party members across the Rio Grande Valley.

“The committee was composed of members from the Brownsville and McAllen Tea Parties, Cameron and Hidalgo County Republican Women Clubs, North Cameron County GOP Club and an SREC committeewoman from Cameron County.”

SREC stands for State Republican Executive Committee.

“The (Lucio) bill was filed on April 7 and has been scheduled for a public hearing by the Senate Intergovernmental Relations Committee on Monday April 13,” Barnes wrote. “Cameron County is going to recruit someone to travel to Austin and testify against the bill. The rest of the group will concentrate on calling the four Republicans on the committee and explaining the negative effect on Cameron County. Further meetings will be planned based on events.”

Dr. Javier 'Jake' Margo
Dr. Javier ‘Jake’ Margo

Barnes said voters should not be fooled by a name charge. Last November, Hidalgo County voters narrowly voted against setting up a “Hidalgo County Hospital District.” Under Guerra’s bill the entity is being called a healthcare district, not a hospital district. “A hospital district by any other name is still an increase in taxes. Vote this down again,” Barnes said.

Although local Tea Party and Republican groups look set to mobilize against the setting up of healthcare districts in Cameron and Hidalgo counties, large numbers of physicians are big supporters. By no means are all these physicians Democrat or Independent.

The Hidalgo-Starr County Medical Society, representing hundreds of physicians, recently passed a resolution in support of a hospital district in Hidalgo County. Such a district already exists in Starr County.

“Our Society is very much in favor of setting up a healthcare district. We have passed a resolution to this effect,” said Dr. Javier ‘Jake’ Margo, president of the Hidalgo-Starr County Medical Society. “The healthcare district is crucial to the UT-Rio Grande Valley School of Medicine being a success, absolutely crucial. It is a way to help fund the med school. It is also a way for the community to take some ownership of this new med school. It is for the people. There will be oversight because the healthcare district will be run by a committee appointed by our local elected officials.”

Margo is a primary care physician who practices in Starr County. He said his county’s only hospital would not exist if it were not for tax raising efforts of the local hospital district. “The hospital district is crucial to our hospital. You can only tax so much and the board has been very sensitive to that. I do not believe there has been a tax increase for years. We have learned to make do with what we have yet still having state of the art equipment and cutting-edge treatments.”

Margo added that medical schools are, by their nature, generally not money making, unless they are able attract research dollars. He said that as the UT-RGV School of Medicine will be primary-care centered, there will likely not be that much research money available. “Although primary care saves health care costs it does bring in research dollars. If you are really trying to build a primary-care centered medical school, which UT-RGV is, you really need to have the support of local tax dollars. The healthcare district will help do this.”

Asked for his response to those who argue that the Legislature or the University of Texas System will always be there to financially provide for a Valley medical school, Margo said: “We cannot rely on the Legislature and the UT System alone. If you do not have a sustainable model and you rely solely on the Legislature… they try their very best but when lean times come they make cuts. Unfortunately we saw that in primary care, we saw that with the HMO roll out, which was supposed to save costs but it has not gone the way it was supposed to go. Now, we have lots of access to care issues. Again, it is crucial we have this healthcare district as the base for the medical school.”

At a recent Rio Grande Valley Leadership class event, Manny Vela, CEO of Valley Baptist Health System, spoke about legislation being filed by Sen. Lucio and state Rep. Eddie Lucio, III, to set up a Cameron County Healthcare District. Vela said: “Yes, it is a great concept. I think it is a good thing to have the ability to create a healthcare district so let us take advantage of this legislative session, let’s get the bill passed, let’s get the bill signed, let’s keep the bill in our back pocket,” Vela said.

“But, before we go to our community in regards to supporting this kind of initiative, let’s go to UT and make sure they supply a budget to us, so we know exactly how the funds will be spent. So, when we go out to our business owners, our property owners, because they are the ones who are going to be taxed, we can legitimately and in good faith and confidence say, listen, this benefits us all in this manner and this is how these dollars are going to be spent. I am not seeing anybody in either county do that right now.”

State Rep. R.D. 'Bobby' Guerra
State Rep. R.D. ‘Bobby’ Guerra

Rep. Guerra’s bill made it out of the House Committee on County Affairs despite quick fire questioning of the author at the hearing by Reps. Stickland and Tinderholt. They said they were asking the questions in response to the concerns of local taxpayers. GOP and Tea Party activist Barnes had helped get those questions to the Republican House members.

Guerra said House Bill 1596 was crafted in response from voters who wanted stronger safeguards put in place before moving forward with the creation of a healthcare district in Hidalgo County. He said the bill would cap the tax rate at 25 cents per $100 valuation; provide all residence homestead exemptions for the elderly and disabled residents, as well as a total exemption for 100 percent disabled veterans and their surviving spouse. Guerra said the budget and tax rate must be approved by the Hidalgo County Commissioners Court to ensure proper oversight and that all rollback tax provisions would apply.

“The Healthcare District is a solution for inadequate access to healthcare in Hidalgo County. It’s a fact that we have some of the highest rates of uninsured individuals and amongst the worst health care outcomes in the nation. HB 1596 would provide Hidalgo County with the proper sanctions it needs to improve on indigent care, as well as leverage and draw down additional federal funds to address health disparities,” Guerra said.

Guerra noted that the Hidalgo County legislative delegation had also crafted House Concurrent Resolution 111. The resolution “strongly encourages” Hidalgo County to decrease its tax rate should the healthcare district be passed by voters and created. This is possible because currently Hidalgo County raises taxes for indigent healthcare. Responsibility for this would shift to a healthcare district. The healthcare district is intended to decrease the burden on taxpayers by taking advantage of federal matching funds, supporters say.

Guerra said the additional federal funds, only obtainable through a healthcare district, would bring millions of dollars into the local economy, create thousands of new jobs, produce an educated and healthy workforce, and a healthier Hidalgo County for all its families and children.

Guerra listed these changes to a Hidalgo County Healthcare District under his legislation:

•           The tax rate is now capped at 25 cents per $100 valuation.
•           The budget must be approved by the Hidalgo County Commissioners Court to ensure proper oversight.
•           All residence homestead exemptions will be provided. This includes an exemption for elderly and disabled residents as well as a total exemption for 100% disabled veterans and their surviving spouse.
•           All rollback tax provisions apply.