Commissioners Court considers its options, postpones Central Health budget vote

Public protest and confusion surrounding the Sept. 12 Central Health Board of Managers vote to dissolve Sendero Health Plans has the Travis County Commissioners Court questioning how to move forward.

Central Health President and CEO Mike Geeslin presented its Fiscal Year 2018-19 budget and tax rates to the Commissioners Court Tuesday morning but asked the court to postpone voting on both until later in the week. The court agreed to wait, in order to give Central Health the chance to call a specific meeting to discuss the budget and the Sendero decision.

Sendero Health Plans is a nonprofit organization that currently insures 24,000 individuals in Central Texas, mostly lower- or fixed-income residents.

The court now faces a dilemma wherein approving Central Health’s budget is approving the decision to dissolve an organization that thousands of Travis County residents depend on to meet their health needs.

“This is a gut-wrenching moral issue, probably more than it is a financial issue,” said Commissioner Gerald Daugherty via video conference.

Although the court cannot technically override a decision made by the Central Health Board of Managers, it has the option to vote down the proposed budget and to remove individuals from the board.

County Judge Sarah Eckhardt referred to the question of voting down the budget as a “nuclear option” throughout the meeting. “If we were to insert ourselves as a decision-maker by voting the budget down until we got the decision that a majority of this court wants, we would have essentially replaced the Central Health board,” said Eckhardt.

Echoing concerns of the public, Commissioner Margaret Gómez explained the difficult position of the commissioners as representatives of their constituents that might be losing health care but also as a governing body whose aim is to entrust Central Health with the power to do what is best for the health care needs of Travis County residents.

The Central Health Board of Managers comprises nine volunteers, four of which are appointed by Austin’s City Council and another four by the Commissioners Court. The ninth manager is jointly appointed by both bodies.

There were many members of the public present to voice their opinions on the Sendero decision, and all of them were against its dissolution. Among them was Central Health manager and Texas congressional candidate Julie Oliver, who was one of three members of the Central Health board to dissent to the decision to cap Sendero funding last Wednesday.

Oliver urged the court to leverage its power to stop the decision. “I respectfully ask you, Commissioners Court judge, to delay voting on our budget. Or if you have to pull the nuclear option, pull the nuclear option so that our board can reconsider our vote,” said Oliver.

The primary concern voiced by the public and the commissioners is what will happen to the 24,000 individuals currently insured by Sendero.

There are currently three other insurance providers available in Travis County under the Affordable Care Act: Ambetter, Oscar and Blue Cross Blue Shield. There was, however, serious public concern about the affordability of and access to those providers.

“There’s been discussion about whether there are alternatives and about the total of four providers on the Obamacare exchanges,” said Morgan Withoff, who spoke during public testimony. “Two of them are Blue Cross Blue Shield. If I go to those, that will cost my family of three approximately $10,000 extra per year out of pocket, which is inconvenient. But there’s a bigger factor, which is the size of the networks that these providers cover.”

Geeslin admitted the uncertainty over what options will be available for these individuals. “They may have an option out there that’s a few dollars less than what they’re paying at Sendero now, or they may have an option that – again, it depends on the person – it could be a whole lot more per month. You know, three digits,” he said.

If the Central Health Sept. 12 vote is to move forward, there are currently two options to choose from. The first option will cap the budget at $24 million and phase out the insurance provider over a year. The second option will use $26 million, with the possibility for another $10 million in funds, and phase out Sendero over two years.

Concluding the hearing, Eckhardt offered her preference for the first option. “My personal opinion is the $24 million cap is appropriate,” she said.

The Commissioners Court will take up the budget vote again during next Tuesday’s voting session.

Photo courtesy of Google Maps.

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