Plan To Put Indigent Care Payment Issue on November Ballot in Travis County, Texas, Delayed One Year

Probate Judge Guy Herman has agreed to postpone his push for a Travis County, Texas, indigent care hospital district on the condition that county officials "formulate a plan in the meantime," the Austin American-Statesman reports. Herman had gathered 100 signatures in favor of a hospital district, enough to put the issue on the November 2002 ballot. But supporters and opponents of the district said they needed more time to consider the proposal because of concerns over who would run the it, how it would be financed and which residents would be included. Currently, indigent care in Travis County, which cost about $32 million last year, is paid for by both the county and the Austin city governments, with the county only paying for care of people living outside the city limits and the city taking on the "lion's share of [the] responsibility" for total indigent care costs. Under a hospital district, all county residents would be assessed a property tax not to exceed 75 cents per $100 of value. Supporters of the district say that it would "more evenly spread the burden of costs" and reduce overall health costs by giving the uninsured a guaranteed source of preventive care, which in turn would lessen the need for critical and more expensive hospital visits. It is unclear whether the proposed district would govern nonemergency clinics and mental health facilities and whether nearby counties could join the district at a later date. The American-Statesman reports that nearly every other large urban Texas county has a hospital district to fund indigent care (Quin, Austin American-Statesman, 7/27).

Overcoming Turf Battles
Although the details of forming a Travis County hospital district are "complex," they are "doable" if government officials can overcome their differences, an Austin American-Statesman editorial says. The district would help reduce the number of uninsured patients, decrease insurance premiums and reduce overcrowding at county emergency rooms, the editorial states, but most importantly, it would create "tax equity" by taxing county residents, who currently "aren't paying their fair share." The editorial notes that Austin taxpayers pay twice -- both city and county taxes -- as much as non-Austin residents, who only pay county taxes for indigent care. The editorial concludes, "[C]ity and county officials should not allow turf or political battles to derail efforts" (Austin American-Statesman, 8/5).