After Sendero shutdown sparks outcry, commissioners postpone vote

Sept. 19--2 p.m. update:

Travis County commissioners on Tuesday agreed to postpone a vote on the county health district's budget.

Commissioner Jeff Travillion said the extra time will give commissioners and Central Health officials time to look over and make public the financials behind keeping versus closing Sendero.

"I think public confidence is predicated on putting it out there and letting them see what we see," Travillion said.

County Judge Sarah Eckhardt said county officials will make sure that if Sendero does ultimately stop offering its plan, officials will make sure members are given the help they need to find new coverage.

11 a.m. update: Central Health president and CEO Mike Geeslin on Tuesday asked the court to postpone a decision on its budget until it can hold a special meeting to allow public a chance to weigh in on the agency's decision last week to close its nonprofit health insurance provider, Sendero Health Plans.

Geeslin said he expected the meeting to be called for Friday or Saturday.

"The board of managers has probably spent more time on Sendero than probably any two, three, four issues combined over the past several months," Geeslin said. "And I'm looking forward to the community today, and I feel that I can safely say this on behalf of all board members that not only the communications today, but in the future public meeting that we're going to embrace all that people have to offer because that helps inform the decision."

Geeslin added that the decision wasn't "just a matter of economics" and that board members didn't make the decision without taking into account the people that it would affect.

"There is this element of taking care of members," Geeslin said. "What does their health situation look like? What do you offer them year in year out that they can rely on?"

Geeslin's comments came after community leaders held a news conference outside the Commissioners Court doors asking the court not to approve the budget with the Sendero closure directive.

Frank Ortega, director of a local League of United Latin American Citizens district, and other leaders criticized Central Health for not being transparent about its decision. They also called for Central Health to move enrollees in its Medical Access Program, a program that provides health coverage but not insurance to low-income residents, into Sendero by providing premium assistance.

Ortega and others have said that would increase federal dollars by decreasing the amount that Sendero has to pay back to the federal government under the risk adjustment provision of the Affordable Care Act. The provision requires insurers with healthier members to pay insurers with sicker members as an attempt to level the playing field.

"Why do rich people get to have a choice for their insurance and the working poor are stuck with MAP?" Ortega said.

Fred Lewis, an attorney and local activist, also called on the Central Health board to release a third-party actuarial report that it discussed before the vote to end Sendero last week. The American-Statesman has requested the report under the Texas Public Information Act but has not yet received a response.

Earlier: Travis County commissioners on Tuesday will consider for approval the county health district's budget, after the agency's board last week made the controversial decision to shut down its nonprofit health insurance provider.

Sendero Health Plans, created by Central Health in 2011, provides its IdealCare plan on the Affordable Care Act marketplace to about 24,000 members. (Sendero in May cut its other two plans, through the Texas' STAR Medicaid program and Children's Health Insurance program, citing projected losses of more than $800,000 a month.)

Central Health board members voted 4-3 last Wednesday to allocate $24 million in fiscal year 2019 to the nonprofit with the condition that it will cease operations within two years. That was part of a $258 million budget it also approved Wednesday that includes a tax rate of 10.52 cents per $100 of taxable value.

Travis County commissioners by state law give final up or down approval of the agency's tax rate and budget in its entirety.

Central Health board members who voted to close Sendero said the uncertainty of whether the Affordable Care Act will exist in the future under an administration largely set on repealing it was too risky and pointed to the nonprofit's shaky financial record. Those against said pulling in new Sendero members from existing Central Health subsidy programs could provide more stability.

Sendero board members still have yet to decide how they'll react to the Central Health vote and whether the nonprofit will provide its plan in any form in 2019.

Regardless, Sendero will continue to offer coverage to its members through the end of the year, officials have said. If Sendero does not offer a plan in 2019, members will have to choose a new plan during the enrollment period that runs Nov. 1 through Dec. 15.

The Central Health board's decision was met with outrage by some in the community, including Frank Ortega, director of a local League of United Latin American Citizens district, which includes Travis County. Ortega wrote a letter to commissioners Thursday urging them not to approve the budget.

"This is going to further add chronic stress to those community members who now have to worry about their health care coverage, and they are the most vulnerable who can least absorb this stress," Ortega wrote.

Sendero members and supporters will hold a press conference at 10:15 a.m. Tuesday, before the commissioners' vote on the budget. A news release for the event said the groups will ask the court to support Sendero to serve its members in 2019 and allowing time in the meantime for public discussion on the issue.

"Sendero members -- especially those in the midst of treating chronic illnesses -- were shocked to learn they would have to scramble to find new insurance," a news release for the conference read. "In many cases, a member's current doctor may not be part of a new health plan choice, forcing the member to find new health providers while trying to maintain treatment."

This is a developing story. Check back for updates.

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