1115 Waiver – Pay Me $1 And I Will Give You $3 Back

beto Beto Salinas

The 1115 Waiver is a federal program meant to provide incentives to taxpayers to become more dependent upon government. It takes political courage to recognize the 1115 Waiver for what it is. Mayor Beto Salinas of Mission, Texas is a rare man of courage………

Push renews for Hidalgo County hospital tax

By SKY CHADDE Staff Writer | Posted 11 hours ago

McALLEN — In November, the prospect of paying a 75-cent tax to fund a countywide hospital district scared a slim majority of voters into defeating the measure. That’s when Sen. Juan “Chuy” Hinojosa promised to introduce legislation to lower the state-mandated tax cap by 66 percent.

Last week, he followed through. And at least one of the measure’s most vocal opponents remained steadfast, even with the changes.

Hinojosa, D-McAllen, and state Sen. Eddie Lucio Jr., D-Brownsville, filed a bill Wednesday that, among a few other modifications, changes the tax cap on such a district — now called a healthcare district — to 25 cents. Anti-tax critics balked at what they viewed as a high cap, even though the starting tax for such a district would have started at 8 cents for every $100 of property valuation.

Hidalgo County residents are already taxed 59 cents for every $100 — the highest county tax rate in the state. But proponents of creating a district say the benefits — reimbursing hospitals and clinics that care for those without insurance and funding the University of Texas Rio Grande Valley medical school — far outweigh the additional tax.

Having one, they say, will even mean less of a tax burden in the future.

“Right now, the county has the responsibility to provide indigent healthcare,” Hinojosa said. “That responsibility is not going away. That cost will continue to increase. The only way to stabilize that cost to the taxpayers and any future increase in property taxes is by drawing down 1115 Waiver money through a health care district and in the long term save taxpayers’ money.”

The 1115 Waiver is to a federal program meant to provide incentives that “promote the objectives” of Medicaid and the Children’s Health Insurance Program, according to Medicaid’s website. Both programs aim to address the healthcare needs of those who can’t afford it.

The waiver would authorize the newly-created district to send taxpayer money to the federal government. Then, the federal government would send the same amount back plus some additional funds.

For every local dollar invested in the district, the federal government would send back about three more, according to Hinojosa’s office.

“There’s a transition period, maybe two to three years, where we’re shifting money and responsibility from the county to the health care district and then drawing funds from the federal government,” Hinojosa said. “It is a complicated process. But if you look at the end result, it is a tremendous benefit to the taxpayers.

“Otherwise, if we don’t create a healthcare district, the healthcare cost will continue to increase and that burden and responsibility will be on the Hidalgo County taxpayers only,” he continued. “By creating this healthcare district, we will let the federal government come in and pick up a match of three to one.”

If the decision goes in front of voters, the ballot will read the district’s tax is capped at 25 cents. But, if voters want to increase the cap in the future, the bill allows for that.


Hinojosa said he arrived at 25 cents after listening to community leaders, such as Mission Mayor Beto Salinas, who advocated for the lowered cap. Salinas took out TV ads opposing the tax increase, saying, “Stop the hospitals and the politicians from getting richer.”

But having a healthcare district is a lot more complicated than just raising taxes, Hinojosa said.

“What happened last time, the issue was distorted by people who opposed it,” he said. “They used slogans — ‘no tax increase,’ ‘no more taxes’ — and it’s a complicated issue that is not easy to explain in just a slogan or a bumper sticker.”

Salinas has said previously he’d be more open to a 25-cent cap, but on Friday he took a hard stand against it. Lots of regular taxpayers and business people have called him and expressed their concerns, he said.

“There’s a tremendous amount of people who don’t want it,” he said. “I’m not in favor of any new taxes.”

Lots of bodies in the county already tax residents, Salinas said, mentioning the STC and drainage district taxes.

“Now,” he asked, “you want to create another body to add to the list we already have?”

Hidalgo County Judge Ramon Garcia said, if the bill becomes law and gets enough signatures to be put on the ballot, the earliest residents could vote on it would be 2016.

Asked if he’d run ads again if it were on the ballot, Salinas said, “I’d have to. I want to sleep at night.”

Salinas’ opposition stems from health care district advocates not being specific enough with where the increased tax money will go, he said.

“They’re not letting the taxpayers know who will get this money,” he said. “(Hinojosa) can file the bill and he can have the election, but they should tell people who will really get the money.”

He said the ballot should be specific about who gets what.

Although the bill does not specify how much money each healthcare service would get, it does say the ballot will read:

“District funds shall be used for district purposes, including improving health care services for residents of Hidalgo County, supporting the School of Medicine at The University of Texas Rio Grande Valley, training physicians, nurses, and other health care professionals, obtaining federal or state funds for health care services, and providing community health clinics, primary care services, behavioral and mental health care services, and prevention and wellness programs.”


Hinojosa has amended a few other things from his previous legislation.

For one, the term “hospital district” has been changed to “healthcare district,” and has been used throughout this article.

“We changed the name because using hospital district was confusing to a lot of people,” Hinojosa said. “This is not to create a new hospital. It’s to provide healthcare services to Hidalgo County.”

Travis County voters approved its healthcare district in 2004.

Also, any budget proposed by the healthcare district’s board would have to be approved by the Hidalgo County commissioners’ court.

“It provides for accountability and supervision by public officials that are elected by the voters,” Hinojosa said.” The county commissioners and the county judge are very sensitive, and they’re the ones that would agree and control the tax rate, including lowering the property taxes by an appropriate amount based on the savings by the creation of a health care district.”

Garcia has said, and reiterated Friday, the county commissioners might lower the county’s tax if a health care district were created. The number floated was 2.5 cents per $100 of property valuation, according to previous Monitor reports.

Also, if passed, the bill would mandate residents in the healthcare district still get their homestead tax exemptions if they’re eligible. For instance, people older than 65, are disabled or are disabled veterans receive the exemption.