Travis County Commissioners Approve Central Health Budget, Including Funds For Nonprofit Sendero

Sep 24, 2018

Update: Travis County commissioners unanimously passed Central Health's budget and tax rate for fiscal year 2018-19. Included in the $258 million budget is $26 million for Sendero Health Plans.

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Our original post continues: 

The Travis County Commissioners Court is scheduled to vote Tuesday on Central Health's budget, which includes money for the nonprofit Sendero Health Plans.

Central Health's board of managers voted Saturday to allocate $26 million to Sendero Health Plans in fiscal year 2019. The decision gives the nonprofit health insurance company enough funding to operate another year under certain conditions. If Sendero's financial woes and enrollment issues do not improve by June, the program will be slowly dissolved.

The nonprofit HMO was established in 2011 and covers about 24,000 Travis County residents.

The board also voted Saturday to give Medical Access Program (MAP) members and other Central Health patients with serious medical illnesses the option to shift to Sendero. The idea is to leverage more money through the Affordable Care Act's risk-adjustment program. Central Health will also subsidize Sendero premiums, according to a press release.

At Saturday's meeting, board Vice Chairwoman Sherri Greenberg said even though Central Health allocated money to keep Sendero going, there's still uncertainty about its future.

"Myriad things" could happen outside its control, she said, because of instability in the health insurance marketplace.

About 50 people attended the meeting and 32 gave public comment – mostly in favor of Sendero – at the more than five-hour special meeting.

Although the budget was passed unanimously, board members didn't pass the chance to emphasize the importance of improving the program.

“When we say that we're going to support our mission, to support the medical and hospital needs of the indigent, of the uninsured, of the working poor, then that's what we're supposed to do,” board member Cynthia Valadez said.

Saturday's vote was a 180-degree turn from a decision made the week before. On Sept. 12, the board of managers voted 4-3 to cap funding for Sendero at $24 million, which would have led to its exit from the insurance market by 2020.

Shannon Jones, who originally supported the wind-down, changed his vote in favor of the new budget, but stated that there be strict guidelines to ensure accountability.

“By placing these triggers into this proposal, I believe we won’t be here next year,” he said.

Sendero has faced funding issues for several years, partially because it has not been sufficiently reimbursed for its IdealCare members. The Central Health Board of Managers voted to invest an extra $26 million into the program in January, resulting in a $36 million FY 2018 budget.

In March, the program withdrew from the STAR Medicaid and Children's Health Insurance Program market, causing about 18,000 members to transfer to new insurance plans. Central Health said insurance premiums couldn't cover predicted care costs for members.

Correction: A previous version of this post misspelled Sherri Greenberg's last name.