Here are excerpts from recent editorials in Texas newspapers:
The Dallas Morning News. Dec. 5, 2019.
Will Texans keep getting hit with surprise medical bills? We may know soon
It is most disheartening when what seems like a victory begins to look like a defeat. All it takes is creative rulemaking, and the best intent of lawmakers on behalf of citizens can be turned on its ear.
Last spring, Texas lawmakers came together in a bipartisan effort to protect consumers in state-regulated health care plans from getting hammered with outrageous bills for out-of-network treatment. Among its many reforms, Senate Bill 1264, which Gov. Greg Abbott signed into law, authorized an arbitration process for insurers and providers to work out their billing differences.
The idea was to prevent patients from being held hostage and ultimately getting stuck with the bill.
However, the Texas Medical Board, the state agency mandated to regulate medical practices, wants to expand a provision in the law that would allow consumers to opt for higher costs if they willingly use an out-of-network doctor for nonemergency care. The medical board’s proposal would extend the narrow exemption to include all out-of-network providers - like anesthesiologists and pathologists - if a patient signs a waiver.
Consumer groups and Lt. Gov. Dan Patrick rightly blasted the Texas Medical Board for encouraging a raft of misleading paperwork that could expose patients to receiving bills for whatever costs that insurers and providers did not pay. In other words, consumers would be back in the middle.
“After passing the strongest ‘surprise billing’ protections in the nation, I am not happy to learn that attempts may be being made at the Texas Medical Board to create a loophole to undermine this important law,” Patrick said in a statement. “Senators are not happy either.”
The Texas Medical Board says there is no attempt to mislead and it would provide patients with enough advance notice to avoid billing surprises. Nonetheless, a loophole by any other name is still a loophole.
The whole point of SB 1264 was to remove patients from being collateral damage in billing disputes. It barred surprise medical bills from being sent to patients who have been treated by out-of-network providers when the treatment is an emergency and clamped down on stunning charges for medical out-of-network care at in-network hospitals and out-of-network lab and imaging work.
Texas lawmakers made clear that they wanted consumer protections to reduce the paperwork jungle and the prospect of patients making expensive missteps.
The clock is ticking. The board will review the rule and public comments at a meeting this month and could direct staff for revisions. The rules need to be in place by Jan. 1.
A surprise medical bill is every patient’s financial nightmare. Lawmakers took important steps to help patients, and the will of the Legislature should be upheld.
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Houston Chronicle. Dec. 6, 2019.
Naturalization delays are unacceptable
There is a backlog of more than 700,000 citizenship applications in the United States - about 80,000 of them in Texas alone. Nationwide, the average wait time of about six months has doubled, but caseloads and staffing mean that in some places, including Houston, immigrants could be waiting up to two years or more for naturalization.
This is unacceptable. Delays in citizenship can hurt people’s employment opportunities, hinder qualification for public benefits including federal student loans and impact the ability to participate in elections.
The Trump administration should be doing all it can to give U.S. Citizenship and Immigration Services the support it needs to eliminate the backlog. Instead, officials seem intent on throwing up roadblocks to make legal immigration and naturalization more difficult and time consuming.
Part of the delay can be attributed to the government giving additional scrutiny to citizenship applications, and while proper care should be taken, people who apply for citizenship have already been vetted when they went through the process of becoming permanent legal residents, an obligatory precursor to naturalization.
They must also meet other citizenship requirements, including having lived in the U.S. for at least five years, a basic understanding of U.S. history and government, good moral character and the ability to read, write and speak basic English.
These are the immigrants whom President Donald Trump and many of his followers say they want: the ones who have done it “the right way” and are looking to “assimilate” further.
But so far, there is a disconnect between words and actions.
After the president was elected, there was a surge in the number of citizenship applications, no doubt motivated by Trump’s anti-immigrant rhetoric, which added to the backlog. But spikes in the numbers aren’t new. Backlogs increased in 2000, 2007 and 2012, but the government dedicated resources to improve processing - something the current administration has been slow to do.
Since Trump took office, it’s not only citizenship applications that are taking longer. Green card applications, travel and work permits, and fiancé visas have seen an increase in processing time. The U visa, meant for victims of crime, has gone from 22 months to almost four years, according to a report by Boundless Immigration, a company that helps immigrants obtain green cards and citizenship.
The administration also wants to increase fees and eliminate waivers for low-income applicants.
Under the proposed fee hike, citizenship costs would climb to $1,170 from $725. Other increases would affect foreign spouses of American citizens, who would see an increase to $2,750 from $1,760 to file a residency application, and Deferred Action for Childhood Arrivals recipients, who would pay $765 to request a renewal of their status, up from the current $495. The government also wants to start charging asylum-seekers $50 for applications and $490 for work permits.
While the higher cost for immigration fees is steep - and doing away with the waiver program must be reconsidered - more than 95 percent of the USCIS budget comes from those fees.
The proposed increase, then, is meant to “ensure recovery of the full cost of administering the nation’s immigration laws, adjudicating applications and petitions, and providing the necessary infrastructure to support those activities,” according to a USCIS statement.
If more resources are to be devoted to reducing the backlog and improving service, then you can argue that larger fees are necessary. But again, the administration’s actions interfere with their words.
The proposal would also allocate more than $200 million from fees to operations by Immigration and Customs Enforcement. It is ridiculous for an agency whose budget in 2018 was more than $7 billion to take money that is needed elsewhere.
The administration must direct all funding to USCIS, reduce the backlog and help those who want to go through the process to become full members of our democracy. If the immigration system as a whole is ever to work, at a minimum we can start by doing right by those immigrants following every step of the law.
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Amarillo Globe-News. Dec. 5, 2019.
Make after-hours clubs a community priority
Welcome to the unregulated world of after-hours clubs, a challenge for cities across the state and nation, and a problem that reared its head with terrifying consequences locally within the past week.
Law enforcement authorities were called to the Hogg Penn Club in the early morning hours of Nov. 29. According to the Amarillo Police Department, seven people were wounded in a shooting that is still under investigation.
The incident provides a window into the underbelly of after-hours clubs, informal gathering spots that operate between the wee hours of midnight and 6 a.m. According to authorities, a wide variety of criminal activity can take place in these types of establishments, but regulating such places is difficult without unintended consequences.
“They are difficult to regulate because writing a rule prohibiting these informal gatherings of adults will inadvertently outlaw legitimate gatherings of friends in a home for a late night fellowship and a drink,” city officials said via email in response to a series of questions we submitted.
These “clubs” are not licensed and therefore not subject to the same set of rules that regulate licensed operations that sell alcoholic beverages. Those who frequent after-hours clubs typically bring their own alcohol, according to city officials, who also noted that alcohol sales at after-hours clubs are against the law.
“After-hours clubs are not licensed clubs subject to the normal rules that regulate licensed bars,” city officials said. “Participants are to bring their own alcohol. A sale of alcohol by one person to another at an after-hours clubs is a criminal offense.”
Complicating matters is the very nature of an after-hours club, which can be something of a misnomer as the club’s location is often fluid due to the fact that illicit activity is often part and parcel of what transpires there. Authorities suggest a laundry list of criminal offenses can happen at such places, ranging from trespassing to drug use to assault to homicide.
“I have no leverage with these places,” APD Chief Ed Drain said during a community meeting in the aftermath of the shooting. “I have a tiny bit of leverage when it comes to their Certificate of Occupancy, but that’s about it.”
The chief noted the department has had some successes against after-hours clubs, shutting them down for illegally selling alcohol or making food at home, and it’s apparent he shares the community’s frustration with regard to these nebulous enterprises. They operate off the radar and in the shadows, which makes regulation even more difficult.
With all of that said, seven people shot at one place at one time is a call to action that cannot be ignored. The city must take on this issue and fashion regulations that will put the squeeze on such activities. As the city noted, other Texas entities have had success in this area, making after-hours clubs a focus.
City leaders should continue to look at the best and most effective practices that already have worked and see how those measures can be applied right here, right now. That will send a message that regulating after-hours clubs is a priority. Likewise, conversations such as the recent meeting at Mt. Zion Missionary Baptist Church should also continue.
Certainly, law enforcement must lead the way, but this is a community issue, and it will take the community working together to solve it.
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