Opinion: Budget, health care and aging tech are grave concerns

Second of two parts

This year, more than 11 million Texans voted. This record turnout shows voters on all sides are invested in electing candidates who will ensure Texas is the best place to live and work. Voters know there’s always more our state can do on that front.

In part one Friday, we described three critical facts — about elementary school reading levels, post-secondary training, and broadband access — that should keep Texans up at night. Today, we’ll share three more that demand attention. All six overlap with our 2021 legislative agenda.

— Sixty percent of Texas households skipped or postponed needed health care due to cost, according to the Episcopal Health Foundation's 2019 Texas Health Policy Survey.

Texas has long had the nation’s highest percentage of residents without health insurance. Even before the pandemic, almost one-in-five Texans was uninsured, and Texas remains one of a dwindling number of states that hasn’t maximized opportunities to leverage federal health care funding.

Less known is how many Texans — both insured and uninsured — skip necessary care due to high costs or the lack of care options.

Before the pandemic, 56 percent of Texas households with insurance, and 75 percent of households without insurance, reported avoiding or postponing health care because of costs. This issue is further magnified in many rural areas, where provider shortages, hospital closures, and a lack of broadband connectivity for telemedicine limit access to care.

Skipping care can have long-term consequences for patients and pocketbooks: Texas ranks among the worst large states in key metrics like deaths from treatable conditions and preventable hospitalizations.

The state should explore options to increase federal health funding, improve price transparency, and implement other consumer-driven reforms that reduce costs for patients. Legislators also should comprehensively address rural health challenges through a combination of telemedicine, provider, and emergency care delivery reforms.

— Fewer than 20 percent of state agencies reported significant progress in modernizing services, and nearly half of the state technology agency’s employees were eligible to retire in three years, according to a 2018 Texas Department of Information Resources report.

Aging, inadequate government technology has grave implications for Texans. Too many state agencies use outdated manual processes, costing Texas time and money. And during this pandemic, Texans have experienced inefficiencies from institutions and organizations that still rely on fax machines — thousands of Texans experienced long wait times for unemployment claims, and public health data was delayed. Further, many agencies lack the technology or personnel to use data in ways that best serve taxpayers.

It took years to create this problem, and the legislature won’t solve it overnight. But legislators can make real progress by taking basic steps, such as creating a revolving fund to support technology investment across state government. The state also can begin to change processes in ways that improve data-sharing and modernize contracting.

— The state currently projects a $4.6 billion budget shortfall, on top of health, education, and pension cost growth.

This year’s intertwined health and economic crises have set the stage for a potentially difficult budget session in 2021. This will require state leaders to think differently about how to prioritize state spending, communicate those priorities to the public, and stick to them with discipline.

The legislature should elevate innovative solutions that address immediate and long-term needs. That includes acknowledging the structural imbalances Texas faces as the tax base shifts, exemptions grow, and unfunded pension liabilities accumulate.

It’s time to work together and bring these facts into conversations about Texas’ future. Let’s prioritize actions to ensure Texas remains the best place to live and work.

Learn more about Texas 2036’s data-driven 2021 legislative agenda at www.texas2036.org/agenda.

Spellings, the former U.S. Secretary of Education, is president and CEO of Texas 2036. Rodriguez, a long-time business and civic leader and former Texas Association of Business Chair, is Texas 2036’s executive vice president.