House Speaker Joe Straus vows to reverse cuts to disabled children's therapy services

Texas House Speaker Joe Straus said Tuesday that lawmakers in the Capitol’s lower chamber would seek to restore funding for disabled children’s in-home therapy services during the upcoming legislative session, potentially reversing the state's course in an emotionally fraught, year-long legal battle.

“It did not work, and it will be addressed in the supplemental budget,” Straus said of the payment cuts. He said the cuts were “well intentioned” but that “maybe they were a mistake.”

State lawmakers in 2015 ordered a $350 million cut to the amount that Medicaid, the federal-state insurance program for the poor and disabled, pays speech, physical and occupational therapists who serve medically fragile children.

A group of concerned Texans, including therapy providers and the families of children who receive their services, filed a lawsuit seeking to block the cuts. They lost, but the legal maneuvering tied up the budget cuts in court for more than a year. State officials announced Monday they would finally begin reducing some therapy providers’ payments on Dec. 15.

In the meantime, health insurance companies in the state’s privatized Medicaid system, known as managed care, began implementing their own pay cuts to providers. That prompted outcry from disability advocates, who said the cuts were causing children to lose access to needed health care providers.

Straus said Tuesday he intended to restore the cuts in a supplemental budget. During every legislative session, lawmakers usually pass a supplemental budget that addresses funding needs in the current two-year budget cycle. A spokesman said Tuesday that Straus would move to fully restore the Medicaid funding.

The Medicaid cuts emerged late in the 2015 legislative session out of private budget negotiations between the House and the Senate. Straus appeared to distance himself from the push for the controversial budget cut, saying Tuesday that the idea originated in the Senate.

In a wide-ranging interview with Texas Tribune chief executive Evan Smith, Straus also shed light on his other priorities for state lawmakers — and exposed some possible fault lines with Lt. Gov. Dan Patrick, who oversees the Capitol’s upper chamber.

Straus said that in addition to allocating funding for disabled children’s health care, he would prioritize funds to shore up the foster care and Child Protective Services systems and make improvements to the state’s mental health care safety net.

At the same time, Straus downplayed the urgency of politically touchier proposals that have risen to the top of Patrick’s priorities list — including an anti-transgender bill regarding bathroom use, which is opposed by business leaders, and proposals to crack down on “sanctuary cities,” a vague designation for municipalities that pass protections for undocumented immigrants. 

On Patrick’s proposed “bathroom bill,” which in many situations would prevent transgender Texans from using public bathrooms that match their gender identity, Straus said the legislation wasn’t “the most urgent concern of mine.” On sanctuary cities, Straus said only a “constructive” bill would find open arms in the Texas House, adding that pro-immigrant protections “may not be as widespread of a problem” as some people think.

Asked about the ideological differences between Straus and Patrick, the House Speaker said his leadership style was different because he is not a statewide elected official. For example, he has not explicitly laid out priority bills for passage in 2017 — in contrast to recent announcements by Patrick — because, he said, “I think the House members would string me up if I said, ‘Here’s your bill — pass it.’”

Straus, an early backer of Jeb Bush who never publicly endorsed president-elect Donald Trump, said he thought the divisive November presidential election “wasn’t great for the country.” Still, he said he looked forward to working with the Republican administration.

Straus said Texas lawmakers could not afford to continue ordering funding increases for border security and called on the incoming Trump administration to shoulder some of those costs.

“It’s time for the federal government to assume their responsibility,” he said. 

Straus also said it was “too early to tell” whether there would be room in the state budget for additional tax cuts in 2017. Falling oil prices have state lawmakers anticipating a budget shortfall when they convene in Austin next year. In 2015, lawmakers approved $3.8 billion in tax relief, including a reduction in the franchise tax rate paid by businesses. 

On education policy, Straus called for reforms to the state’s school finance system, which the Texas Supreme Court upheld as constitutional in May while sharply criticizing it as in need of improvement. “If we do nothing, it will be truly a crisis that we will be responsible for,” Straus said. 

As far as “school choice,” another of Patrick’s legislative priorities, Straus said the House would “keep an open mind.” He said he favored giving parents the right to choose where they send their children, whether that be to charter schools, to a variety of public schools within their school district or, in some cases, to schools outside of their district.

But Straus was less embracing of private school vouchers, a topic Patrick favors. “If the focus of the session becomes on vouchers, then there could be some" resistance, he said.

Read more related coverage:

• Texas officials announced Monday they would finally enact cuts on Dec. 15 to Medicaid payments for disabled children's therapy services.
• In September, Texas House Speaker Joe Straus previewed the next legislative session, saying it should focus on making sure children and other vulnerable Texans are not left behind as the state grows.