The Dallas Morning News. Dec. 6, 2020
Lawmakers can end Texas’ dismal record on maternal mortality
The lives of many mothers are at risk.
When lawmakers return to Austin next month, they’ll have a list of unfinished business. Near the top of this list is reducing the number of mothers who die after childbirth.
Last session, the state House passed legislation to provide 12 months of Medicaid coverage to mothers following childbirth. Medical experts, health care advocates, the state’s Maternal Mortality and Morbidity Review Committee and this editorial board backed that bipartisan bill only to see it fail when the state Senate took no action before the deadline to consider legislation.
Lawmakers must not allow this issue to fall through the legislative cracks again. The lives of many mothers are at risk, and this situation has lingered unresolved through several legislative sessions. In its report to lawmakers, the state committee found that 89% of pregnancy-related deaths it reviewed since 2013 were preventable and 31% occurred 43 days to one year after the end of pregnancy.
The committee’s review also found significant racial disparities in the overall rate of severe maternal morbidity, which the Centers for Disease Control and Prevention defines as unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a woman’s health. Although the rate remained relatively stable from 2011 to 2018, the rate for Black and Hispanic women worsened.
In 2018, for example, the severe maternal morbidity rate for Black women in Texas was 299.4 cases per 10,000 delivery hospitalizations, significantly higher than the overall state rate of 182.3. Hispanic mothers also posted higher morbidity rates, signaling that being poor, Hispanic or Black increases the likelihood of death after delivery.
A Georgetown University study ranks Texas last at 25.5% in the rate of uninsured women of childbearing age, which is another reason to extend coverage to 12 months. Statistics show that leaving mothers without coverage during the vulnerable postpartum period is at the root of the problem. When women lose health coverage soon after giving birth, many stop taking medication or are unable to obtain support for postpartum depression.
We are pleased the state committee’s latest report reminds lawmakers of their responsibility to “help identify and properly manage health conditions before they become life-threatening.” The report also notes that cardiovascular, coronary conditions, mental disorders, obstetric hemorrhage, preeclampsia, eclampsia, infection, embolism and even suicide and homicide are deadly conditions that medical care during postpartum could mitigate.
In addition to extending coverage, we urge lawmakers and communities throughout Texas to increase awareness of postpartum patient safety issues that can escalate and cause deaths and to look to other states for best practices that can make motherhood safer for the most high-risk populations.
Another legislative session must not come and go without lawmakers taking action on this pressing issue. Lawmakers know the crisis. Now they need to address it.
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Amarillo Globe-News. Dec. 3, 2020
City on right track in exploring other Civic Center options
It’s been just more than a month since the voting public made its voice heard and thoroughly rejected an ambitious proposition that would have transformed the Amarillo Civic Center complex and produced additional momentum throughout the city’s downtown district.
Perhaps the $319 million overall pricetag ($275 million in the bond proposal) was too steep, and it was a huge ask in this time of economic uncertainty. Likewise, perhaps a number of people were scared off as a result of a campaign that incorrectly insisted property taxes would increase dramatically. Either way, the deal won’t be done – at least as it was proposed on the ballot.
Virtually everyone agrees the Civic Center is badly in need of an update and doing so would put Amarillo on more secure footing as far as retaining and bringing events to the community. The more events, the more people staying in hotels and motels, eating in restaurants and shopping with retailers. Increased economic vibrancy also is something virtually everyone can get behind.
Toward that end, Mayor Ginger Nelson earlier this week appointed a committee to take a deep dive into viable alternatives in getting the project back online. The group’s top priority for now is to look into possible public-private funding options as a way to reduce the cost and accompanying sticker shock.
“Many people are telling me they’re for the project, but with COVID and all of the uncertainty, that it just wasn’t the right time,” she said in our story. “Some people are even saying there were public-private funding options that we could have looked at. I think we need to do that as quickly as we possibly can, so I’ve appointed a small committee to go and gather more information on public-private partnerships.”
We applaud the city’s efforts to see what other possibilities might exist as far as getting this job done at a lower cost. One of the regular questions to surface from the public throughout the Civic Center campaign asked if it could be done in phases. The project had a number of moving parts that were dependent on each other, and it made sense to wonder if a big project could be broken down into a handful of smaller projects.
Whether that emerges as a possibility remains to be seen. As Nelson pointed out, there is a sense of urgency to this committee’s work as some possibilities could require legislative approval. The legislature convenes next month with the usual abundance of priorities and a pandemic-sized budget gap to deal with.
“One of the reasons that we are trying to move so quickly is if some of these options involve seeking legislative approval, we need to get right on that,” Nelson said. “The committee needs to quickly talk with our legislators and see if there is anything there that we could possibly reduce the cost for this project.”
The committee will also spend some time looking at how other Texas communities were able to get similar projects done. Undoubtedly, their expertise and best practices will be beneficial to the city.
The good news here is Amarillo’s elected leaders are looking for ways to move forward on a project vital to the city’s long-term economic health. They heard the message and they are reacting to it – because the original need has not gone away.
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Fort Worth Star Telegram. Dec. 3, 2020
Here’s why the Texas Legislature probably won’t do much to help the Fort Worth area
Local government and business leaders are drawing up their wish lists for next year’s legislative session. And there’s plenty that lawmakers could do for the Fort Worth area when they go back to work in January.
But between the coronavirus pandemic, a recession-shocked budget and general uncertainty about future needs, many of those wishes may go unfulfilled. If the Legislature does no harm to local government and schools, that may constitute victory for Tarrant County and the region.
The pandemic casts a pall in several ways, but in practical terms, it will probably limit how much legislation lawmakers can even consider. Given the danger posed by indoor gatherings, House and Senate committees won’t be able to have many hearings on bills, so they probably won’t take up the myriad of issues, large and small, that they usually do.
Two immediate priorities must be helping small business and protecting school funding.
Any significant financial help will have to come from Washington. But Texas can help ease the pain for small business in particular. The state should look for ways to lift tax and regulatory burdens for such firms as much as possible.
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