AUSTIN, Texas – The entire South Texas legislative delegation, in a bipartisan fashion, has criticized a proposed new rule from the Health & Human Services Commission that would reduce funding to local hospitals.

Currently, hospitals receive state funding to offset losses dues to serving a disproportionate share of Medicaid, low-income and uninsured patients. This would change under a proposal from Cecile Erwin Young, commissioner of Texas Health and Human Services. Instead, funding would be allocated as a percentage of the hospitals costs. 

“The proposed changes will have a significant and negative impact on the healthcare safety-net in the South Texas border region by reducing funding to the Hidalgo Service Delivery Area (SDA) by approximately $80 million annually,” the South Texas legislative delegation states. 

Commissioner Young was appointed to her position by Gov. Greg Abbott. The South Texas delegation is hoping Abbott quickly puts a stop to her proposal. 

The South Texas legislative delegation says Young’s proposed rule change would be very damaging to South Texas hospitals and reward inefficiency. 

The delegation has penned a letter to Gov. Abbott and Commissioner Young and delegation produced a chart which shows how South Texas hospitals would lose out. To make matters worse, the legislators say, the rule change would be implemented retroactively.

Here is the letter:

Dear Governor Abbott and Commissioner Young,

We write to you out of deep concern regarding a proposed rule published by the Health and Human Services Commission (HHSC) on April 14, 2023 regarding changes to the Disproportionate Share (DSH) and Uncompensated Care (UC) programs.1 The proposed changes will have a significant and negative impact on the healthcare safety-net in the South Texas border region by reducing funding to the Hidalgo Service Delivery Area (SDA) by approximately $80 million annually. Additionally, the rule is being proposed in middle of the program year and is to be applied retroactively which will result in millions of dollars in recoupments from safety-net hospitals all across the state, including Laredo and the Rio Grande Valley.

The South Texas border region is a vibrant, fast-growing region of the state that is rich in culture, steeped in tradition, and family oriented. However, our region does face some challenges with a poverty and uninsured rates exceeding 25%, and with 30% or more of the population being eligible for Medicaid. The Hidalgo SDA is served by only one small public hospital in Starr County with the remaining hospitals in serving as safety-net hospitals.

The DSH and UC programs are intended to bolster the State of Texas’ healthcare safety-net by allocating funding to hospitals which provide a high proportion of care to Medicaid, low-income, indigent, and uninsured persons. These programs help offset losses incurred by hospitals for providing care to the most vulnerable. However, the proposed rule undermines the purpose of the DSH and UC programs and its impact will destabilize the healthcare safety-net of the Rio Grande Valley.

The proposed changes to the DSH and UC program are dramatic in scope and threaten to undermine the purpose of these vital programs, as well as create incentives for reduced efficiency in the delivery of healthcare services and increased healthcare costs for the indigent. We urge HHSC to withdraw the proposed rule without delay.

Nine South Texas lawmakers have signed the letter. They include state Senators Judith Zaffirini of Laredo, Juan Hinojosa of McAllen, and Morgan LaMantia of South Padre Island. They also include state Reps. Richard Peña Raymond of Laredo, Ryan Guillen of Rio Grande City, Armando Martinez of Weslaco, Sergio Muñoz of Mission, Oscar Longoria of La Joya, Terry Canales of Edinburg, R.D. ‘Bobby’ Guerra of McAllen, Erin Gomez of Brownsville, and Janie Lopez of San Benito. 


Cecile Erwin Young

Cecile Erwin Young was appointed executive commissioner of the Texas Health and Human Services Commission by Gov. Greg Abbott, taking leadership of the state’s largest agency on Aug. 14, 2020.

Young previously served as acting executive commissioner from June 2018 to October 2018 and most recently as chief deputy executive commissioner. From 2007 to 2011, she served as associate commissioner for health coordination and consumer services at HHSC and returned as chief of staff in January 2015.

Young has over 35 years of state government experience in Texas. She began her state career as a lecturer and research engineer at Texas Tech University and then served as a conference committee clerk for HB 7, which created HHSC in 1991, and she came to work at HHSC to implement the legislation.

Young has served with four Texas governors, an attorney general and a state representative. She has performed budget and policy work since 1987.

Editor’s Note: The Rio Grande Guardian International News Service will post the reaction of Commissioner Young as soon as we have it.

Editor’s Note: The main image accompanying the above news story shows the Brown-Heatly Building in Austin that houses the Texas Health & Human Services Commission.

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