On Thursday, March 3, United Way of Metropolitan Dallas hosted our annual Lunch with Legislators, where local policymakers discussed some of the most important topics that impact our region in the areas of education, income and health.

Our panel included Sen. Royce West of Dallas County, Rep. Nicole Collier of Tarrant County and Rep. Matt Shaheen of Collin County, who joined us for a virtual conversation that ranged from public education to mental health and the expansion of Medicaid. Our moderator was Ross Ramsey, Executive Editor and Co-Founder of The Texas Tribune, and the event was graciously presented by Haynes and Boone, LLP.

Ross Ramsey: What do you see as the biggest issues in public education for the 2023 legislative session?

Rep. Collier: Because of the schools being away for so long, the learning gap has increased, especially for people of color. We need to make sure that there are wraparound services. And I believe that the legislature should step away from the curriculum; that’s why we have the State Board of Education. When we interject ourselves into the curriculum, with banning books and so forth, I believe that we’re usurping the power that has been provided to another government entity. In terms of money, we need to make sure we pay our teachers adequate, livable wages, that cost-of-living increases happen for our retired teachers, that we don’t overprice them for health care—I could go on and on about what we need to do in education, but that’s where I’ll start.

Rep Shaheen: Miss. Collier’s right, in that there’s a big gap that we need to address right now with our students. They’ve been isolated for a long period of time, different school boards handled COVID differently, some shut down longer than others, some were successful with virtual education. So, I think we have a gap, a lot of which is in our low-income communities. Some of that has to do with the fact that there’s a lot of Texas children now who are in unstable environments—they might have a single mom who’s struggling to make ends meet, she might have two jobs and for her to have time to work with her child in a virtual setting is going to be challenging. We’ve got some neighborhoods that aren’t safe. There’s a lot of factors that are really impacting our children. The children who are experiencing this gap are our fastest-growing segment in Texas. Figuring out how we address those gaps is going to be vitally important. We’re so grateful for our teachers and our principals. I tell them they’re the greatest economic driver in Texas, because they’re literally building the next workforce. These companies that are moving here, a lot of it is because of our workforce. It’s organizations like United Way, our nonprofits and faith-based institutions that are really investing in our children, and certainly, we have a role to play in government.

Ramsey: Senator, you’ve seen what’s happened with students’ test scores over the last couple of years. They’ve slipped quite a bit. How do we catch them up, and what can the legislature do there?

Sen. West: We’ve got to make sure that school boards have the flexibility they need to customize solutions to some of the problems that we continue to see. The state government needs to hold them accountable. We’ve got to make certain that we provide for our future. We did see some of the [test] scores rise prior to COVID. So, some of those solutions that were put into place by local school boards need to be dusted off and put back in place. Obviously, we’ve got to make certain that we continue to support our teachers and our retirees so we can attract teachers to the profession. If we continue to do the same thing over and over again, we don’t get the results we need. It’s agencies like the United Way, and different work groups within, that need to make certain that they collaborate with public officials to come up with solutions where we can work together and provide resources—not just financial resources but also the people who have the experience to deal with some of these issues effectively.

Ramsey: We’re going to come into the next session with $12-$13 billion in a rainy-day fund. What are some of the priorities in terms of health and human services as you look ahead to the next session?

Rep. Shaheen: Broadly, I’m excited about the opportunity to look at changing the delivery model of health care in Texas. We’ve had debates about whether to expand Medicaid and funding levels and those types of things. The problem in Texas is, we have a lot of doctors who won’t take Medicaid to begin with and you go to areas of the state where there’s not sufficient health care services—there aren’t doctors there. I was down near Fair Park recently, and there aren’t doctors there. As a state, why don’t we start piloting different programs to deliver these services? Let’s look at HSA type approaches or cash-based approaches. It’s a whole lot more complicated than expanding or adopting a program; we’ve got a complex, large state, but we’ve also got a lot of smart people.

Ramsey: Should we expand Medicaid?

Rep. Shaheen: There’s a financial impact to it. It’s going to be billions of dollars, so let’s talk about where that money’s coming from, because we’re not going to come into every session flush with cash. Sometimes we’re going to come in with a shortfall of $12-$13 billion. A lot of other states that expanded Medicaid had to make some serious education and health care cuts because of it. I don’t think that will work because most doctors don’t take Medicaid patients, and the areas we need to expand health care access, there aren’t physicians there to begin with.

Rep. Collier: My opinion is that we definitely need to expand Medicaid. My people are everyday Texans, working hard, trying to make ends meet. You talked earlier about underperforming communities; let’s talk about why that is happening. What are the barriers for them to be successful? Then we can get to the root of the issue and help put measures in place to help them be successful, like “ban the box,” [which would remove the conviction history checkbox on job applications]. Maternal health care: extending Medicaid after birth. We got it to six months this year, but it needs to go back to 12. We have a high rate of African Americans dying from childbirth. If we want to talk about helping people succeed, we’ve got to get to the root of the cause. The federal government was going to pay for 90% of Medicaid when it came out, and we turned those dollars away. And this 1115 waiver, [which is a way to temporarily expand Medicaid], it’s a creative solution but it’s not workable all the time. Our hospitals are having to put the money up first, and then seek reimbursement. And the state has to get it renewed. I think that if we expanded Medicaid, if more dollars went to our counties, we wouldn’t have as much uncompensated care, and then they wouldn’t come to the state legislature, asking us to make up the difference.

Sen. West: When the federal government first came out with Obamacare, Texas would have received $10 billion a year. It was backed by various chambers of commerce in Texas, various physicians’ organizations. It had overwhelming support, but my colleagues on the Republican side said no, it would cost too much in the long run. So, organizations have come up with different economic models showing that we can expand Medicaid without putting taxpayers in a hole.

Rep. Sheehan: The results have been different. Go look at the states; they’re still talking about inefficient access to health care. Look at California, Illinois, New York, some of the red states. Again, we can talk about expanding Medicaid all you want, but if there’s no physicians in that community, it doesn’t have an impact.

Sen. West: You mentioned pilot programs, it seems we could explore programs that would incentivize physicians to go into these areas.

Rep. Sheehan: And I agree with that. I talked about the Fair Park area within Dallas, there are no physicians there. It’s not all that safe…even though there’s been some great transformational work done by churches, United Way and others. That area is being transformed and I think a lot of these issues, whether it’s health care or education, will actually be addressed there. But, physicians aren’t incentivized to go there. But it’s also grocery stores—there are no grocery stores.

Ramsey: Is there an opportunity for the legislature to step into that?

Rep. Sheehan: No, because I’ve talked to the grocery stores. I talked to one grocery store company that gives tens of millions of dollars in philanthropy. I said, why don’t you open a neighborhood grocery store in this community and have the expectation that you’re not going to make money. And it won’t work. I don’t know if it’s the legislature or not. What I’ve seen work with my own eyes is, you have a community that was a dangerous area, and churches and nonprofits came together and transformed that area. It’s now a farm with people selling fresh vegetables to restaurants. I’m open to talking about the government’s role and all that, but we’ve been talking about it for six decades. It’s not working.

Ramsey: Senator, tell me about your district and what you see there.

Sen. West: The things the representative is talking about, they’re true. But I’ve also seen a lot of those areas transformed, like Bonton Farms near Fair Park. I think that’s why organizations like United Way are important. Some of the issues I have in the Southern Dallas district, including crime, poverty, underperformance in schools—that’s been the story of our lifetime. The question is whether we pass that on to future generations when we have monetary and academic resources and expertise to deal with these issues.

Ramsey: Rep. Shaheen, you’ve been working a lot of mental health. Where are we on mental health?

Rep. Sheehan: I think people’s perspective on mental health has evolved during COVID. When I first entered the legislature in 2019, I thought Texas was behind on this topic. We’ve been making some really significant progress over the last few years. In one legislative session, we funded $500 million for [mental health] facilities upgrades. But it’s such a complex issue to tackle. You can have somebody who had a heart attack, and give them heart surgery, and they’re on the road to recovery. Mental health doesn’t work that way. You have to figure out the chemical balance in people’s brains and the trauma they’ve experienced. It’s a very difficult and often tragic situation that we’re dealing with. My focus is really with our school children now. I’m highly concerned. They’ve been isolated. I’ve talked to our school board trustees, our teacher, our principals, and they’re highly concerned about it too. Being a teacher is such a hard job now. It tears you up to think about what some of our teachers are having to deal with. I think we’re going to have to leverage our mental health entities and look at how they can support our schools more. I think there’s a model there that will make it more effective beyond what our school districts have to invest in terms of mental health.

Rep. Collier: I agree with you. In addition to our schools, we need to fund programs where there’s a partnership between mental health providers and law enforcement. And we can do that at the legislature.

Sen. West: North Texas has seen, over the last few months, a lot of superintendents retiring. A lot of it’s just burnout. I agree with my House colleagues, that mental health in education is a non-partisan issue.

Ramsey: Rep. Collier, we have a teacher shortage. Are we giving teachers the support they need?

Rep. Collier: I think we need to let them teach, let them have flexibility. They get into this with heart, to provide nourishment to our children, so let’s let them teach instead of putting all these constraints on them—you can’t talk about that, you can talk about this, but only if you also talk about that. I also think safety is an issue, not only with guns in the classroom, but also with COVID. So there’s a lot on our teachers, and I think we can retain them more if we remove some of the constraints we put on them to do their job.

Sen. West: We should allow teachers to have academic freedom. As a legislature, we need to continue to look across this country to figure out what teachers are actually making, and let’s make certain that they have the compensation equal to their responsibility.