Austin American-Statesman. June 10, 2024.

Editorial: Texas’ high court loses a chance to clarify abortion law and help save lives

The Texas Supreme Court had a chance to offer compassion and much-needed clarity on the state’s punitive abortion laws

It could have been their own daughters. It could have been the mothers of their children. But after listening to the harrowing accounts of 20 Texas women denied abortions despite grave complications, the Texas Supreme Court on May 31 upheld a vague and unsparing abortion law. Its effect, said one woman faced with carrying a fatally ill fetus, was “ emotional torture. ”

Zurawski v. Texas, named for lead plaintiff and Austin resident Amanda Zurawski,demanded more clarity on the state’s sweeping abortion ban. In 2022, after the U.S. Supreme Court overturned Roe v. Wade and the constitutional right to abortion, Texas enacted a law prohibiting almost all abortions. Guidance on the law’s interpretation and potential enforcement, the 22 plaintiffs said, would confirm for doctors the exceptions that would allow medically needed abortions. As it stands, a doctor who misinterprets the law can face fines of up to $100,000 – or life in prison.

The court rejected this demand. In so doing it upheld a legal status quo that exposed Texas women with complex pregnancies to physical harm. For any hope of relief in these complex cases, Texan families likely will need to wait until the Legislature meets in January 2025.

What remains is a tragic and dangerous chasm. On one side: judges and lawmakers who assure us that Texas’ abortion ban is clearly stated. On the other are families and the physicians, hospitals and attorneys who have excellent reason to fear that even medically necessary abortions could land them in the crosshairs of state prosecution.

The court did grant one of the 22 plaintiffs, Houston obstetrician-gynecologist Dr. Damla Karsan, standing to sue the state over enforcement of the abortion ban. But the court also upheld a narrow reading of the ban, stating a pregnant patient’s condition must be “life-threatening” before qualifying for abortion. A risk to the mother’s health is not qualification alone.

The 20 women who lived through the consequences of this ambiguous law showed immense emotional stamina describing its effect on their doctors and themselves. In 2022, Zurawski was overjoyed to be pregnant after a year and a half of fertility treatments. But when at 18 weeks her water broke, her doctor told her that her baby could not survive and that she was vulnerable to infection. Under Texas law, the presence of a faint heartbeat meant her doctor couldn’t end the pregnancy because she was not in “medical emergency.” After three days, Zurawski’s temperature soared, her blood pressure sank and her body went into life-threatening sepsis. Only then could she legally terminate the pregnancy.

No clarification on many conditions

Acknowledging this near-tragedy, legislators in their last session tweaked the state health code. It now gives an affirmative legal defense for doctors who use “reasonable judgment” treating a premature water break, such as Zurawski suffered. But the justices’ recent opinion does not clarify the law on any number of other devastating pregnancy conditions.

Stating that abortion is permitted if a physician deems the woman faces loss of her life or “major bodily function,” the court noted that death does not have to be imminent. But pregnancies are not neatly divided between healthy – or life-threatening. And doctors are right to suspect that their emergency judgment calls may be snared in political attacks.

Dallas-area mother Kate Cox, whose baby was diagnosed with a fatal fetal condition, saw this first-hand. Less than 48 hours after a lower court issued a temporary restraining order on the state’s ban, authorizing abortion for her, Texas Attorney General Ken Paxton petitioned the state Supreme Court to overturn it. Paxton then wrote to three hospitals warning legal action if Cox’s physician performed an abortion there. Cox left Texas for the procedure.

Heated conflict on interpreting the law

Yet despite heated conflict in the legal and medical communities about how to interpret the ban, the Texas Supreme Court upheld it as it stands. The court instead placed responsibility for the ban’s effects squarely on doctors, writing “A physician who tells a patient, ‘Your life is threatened by a complication that has arisen during your pregnancy, and you may die, or there is a serious risk you will suffer substantial physical impairment unless an abortion is performed,’ and in the same breath states ‘but the law won’t allow me to provide an abortion in these circumstances’ is simply wrong in that legal assessment.”

But doctors are not lawyers. Interpreting the ban already has involved more than a year of consideration from the state Supreme Court, reversal of a lower court’s block for women with dangerous pregnancy complications, and hours of openly contradictory testimony by medical and legal experts before the Texas Medical Board. What doctor can parse legal issues while treating a patient’s emergency?

Even in the 21st century, amid the immense medical expertise of Texas , carrying a baby involves risk. The 20 women who described their worst-case experiences are not outliers who reflect small flaws in this vast abortion ban.

They are part of the natural continuum of human reproduction.

What is unnatural is the Legislature’s fiction that there are only two kinds of pregnancy: healthy or deadly. Human reproduction is a series of nuanced, deeply personal turning points. Deciding how to address these turning points is a right, and sometimes a heartbreak, belonging solely to patients and the doctors entrusted with their care.

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Dallas Morning News. June 16, 2024.

Editorial: Texas GOP, Dems agree on housing crisis. Are they wrong about the solution?

Cities should loosen zoning without targeting single-family neighborhoods as the problem.

When lawmakers return to Austin early next year, housing affordability — most notably reducing property tax burdens — will be a top priority. Gov. Greg Abbott also has signaled that he wants to do something about the impact of institutional investors buying up residential properties for rental on the supply and cost of single-family homes across the state.

There is also growing pressure to reform land use policies. A growing chorus of real estate experts, urban planners, cities and elected officials now say Texas also should adopt more flexible land use and zoning policies to ease housing availability and affordability crunches. A popular policy prescription involves reducing minimum lot sizes to permit multiplexes and townhomes to be built next to single-family dwellings, which advocates say would expand housing supply and stabilize housing prices.

We have a housing supply problem, so it’s no surprise that Texans on the right and the left have taken up the issue as a policy priority. If zoning is so onerous that homebuilders don’t have flexibility, Texas won’t be able to solve that supply problem. But state and local governments must take a more nuanced view of zoning than what leading partisan voices are offering.

The Texas Public Policy Foundation, an influential conservative think tank, recommends that lawmakers abolish minimum lot sizes and adopt “no use” zoning to allow a lot to be used for just about any purpose that doesn’t run afoul of nuisance regulations. Meanwhile, the Texas Democratic Party’s platform calls for “ending racially motivated exclusionary forms of zoning,” with some people in the party arguing that single-family zoning is discriminatory.

When political polar opposites recognize the same problem, it’s worth working hard to find bipartisan consensus. We are concerned that Lt. Gov. Dan Patrick and House Speaker Dade Phelan are expected to push for statewide zoning reform to curtail local zoning powers of cities. This is likely to pit the big blue cities in the state against the conservative Legislature in yet another battle of state rules vs. local autonomy.

Cities have to be more flexible in their land use policies, but ham-fisted efforts from state lawmakers to limit zoning and other local government powers risk unintended consequences that we worry won’t allow cities to make adjustments unique to their markets.

The solution, in our view, is not to get rid of minimum lot sizes or to curtail single-family zoning. Cities must respect existing neighborhoods and the investments that residents made based on rules that existed at the time they bought their homes. But officials must loosen zoning rules in other areas of their cities to incentivize home construction on undeveloped land and in commercial districts, where land can be tapped for more density.

The exodus of people and industries from high-cost states like New York, California and Illinois to Texas is in part due to Texas’ longstanding competitive advantage as a more affordable place to live. The state’s largest metropolitan areas have become more expensive, narrowing the historical advantages that Texas has had over rival states and cities. This is especially true in the “Texas Triangle” of high-growth counties surrounding Houston, Dallas-Fort Worth, Austin and San Antonio.

The Texas A&M University Texas Real Estate Research Center has estimated that between 2020 and 2023, the annual median price for a house in Texas rose from $259,990 to $335,100, a 28.9% increase. And that’s before property taxes, which are among the highest in the nation, and skyrocketing insurance premiums from violent weather costs and other factors that drive up the costs of homeownership.

This is an opportunity for neighborhoods, state and city governments to be collaborative partners. There are ways to protect existing neighborhoods and also provide housing options for other Texans. Our state is not going to stop growing, but it must be affordable and livable.

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San Antonio Express-News. June 13, 2024.

Editorial: Texas election law threatens voter confidentiality

A sense of alarm about the erosion of voter privacy has been growing among Texas election officials the past few months. It came to a head on June 6.

That day, Christina Adkins, the director of the elections division of the Texas Secretary of State’s Office, sent a memo to county election departments across the state with “emergency guidance on voter privacy.”

It was prompted by the latest example of what has become an all-too frequent occurrence in Texas: state lawmakers tampering with election rules and forcing flummoxed administrators on the ground to deal with the mess.

Adkins’ memo concerned the implementation of HB5180, which Gov. Greg Abbott signed into law last year and took effect in September.

The new law requires county election administrators, in response to open-records requests, to make available “images of voted ballots” or “cast vote records,” beginning on the first day after the completion of the final canvass for an election.

Beginning 61 days after an election, those county election offices must allow for the public inspection of “original voted ballots.”

The law specifies that election departments should redact any personal information from those ballots before making them available for public viewing.

The problem, as election officials define it, is that by allowing self-appointed voter-integrity activists to gain access to more and more election information, the state has made it possible for members of the public to gather voter data points, cross-reference that data and identify the ballots of particular individuals.

That means your right to privacy, to maintain the confidentiality of how you fill out your ballot, is endangered.

That danger is particularly high in small counties, small precincts and low-turnout races, where it’s easier to match the publicly released information with particular voters.

“What bothers me is that people cannot vote in secret in the United States,” Williamson County District Attorney Shawn Dick recently told Votebeat Texas. “If people’s ballots don’t remain anonymous, that’s a huge affront to our system of government and our system of elections.”

Last month, right-wing website Current Revolt published what it claimed was a screenshot of the March 5 GOP primary ballot cast by Matt Rinaldi, who was then the chair of the Republican Party of Texas.

On March 26, Williamson County poll-watching activist Laura Pressley filed a lawsuit in federal court over this very issue against Adkins, Texas Secretary of State Jane Nelson and three county election administrators.

In the lawsuit, Pressley and her fellow plaintiffs place no blame with the Texas Legislature. She pins the ballot privacy crisis on election officials for what she describes as the “willful and systematic disregard of valid, constitutional federal and state election laws.”

In particular, the suit targets the use of electronic voting systems for in-person voting.

“Unlike Texans who are permitted to vote by mail,” the lawsuit argues, “if Plaintiffs wish to participate in the election process in their respective counties, they must use a voting system that contains uncertified and illegal components that breach the secrecy of Plaintiffs’ votes.”

This is a common refrain from election-fraud activists, who regard electronic voting machines as systems that can be easily manipulated to alter election results.

This paranoia has intensified since the 2020 presidential election, when then-President Donald Trump refused to accept his defeat and a number of his allies raised unsubstantiated claims about voting machines being rigged.

Heightened distrust of our election system has led to an increase in open-records requests for voter information in Texas and other states. Election officials say that Texas has moved so far into the realm of election transparency that it’s compromised the confidentiality of the voting process.

“What we have discovered, and I think what a lot of election officials as a community have been very worried about, is that as we’ve increased this level of transparency, it has made this information easier to discover,” Adkins told the Texas Senate’s State Affairs Committee on May 30.

Because the breaching of voter confidentiality is achieved through a combination of data, the June 6 memo from Adkins acknowledged that no single action could be taken in all counties and all cases to guarantee privacy.

So the memo suggests some possible redactions, such as precinct information and/or a ballot number on the ballot image, presiding judges’ signatures, the location at which a voter cast their ballot on the early voting roster, and serial numbers and time stamps on electronic pollbook reports.

These recommendations can provide a Band-Aid, but the underlying problem must be solved by the Legislature. They contributed to this problem, and they should work to fix it.

The 2025 legislative session must include a serious and detailed discussion about how to protect voter privacy.

If we lose that, all other considerations about election integrity become moot.

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AIM Media Texas. June 14, 2024.

Editorial: State should rethink removal of nonprofit health systems from Medicaid, CHIP programs

Texas officials should rethink their decision to drop nonprofit healthcare systems such as the Driscoll Children’s Health Plan from its list of Medicaid and Children’s Health Insurance Plan recipients. The change reduces the number of recipient companies — and options for low-income residents enrolled in the benefit plans.

The decision can affect the healthcare options of nearly 2 million of our state’s neediest residents, including thousands in the Rio Grande Valley. It could force nearly half of Texas’ residents who receive those benefits to find new doctors, hospitals and pharmacies.

Driscoll Health CEO Craig Smith recently noted that it has been part of the state program for two decades and the loss will affect 190,000 Medicaid STAR and CHIP members in South Texas.

The Texas Health and Human Services Commission recently announced the plan to remove nonprofit health systems from government programs including CHIP and Medicaid STAR, which funds regular and emergency medical care, prescription medications and vaccinations for low-income children, pregnant women and families. Their removal has drawn widespread opposition from insurers, doctors and elected officials including U.S. Sen. John Cornyn, who recently toured the new Driscoll Children’s Specialty Center in Edinburg that opened last month, and 19 South Texas lawmakers, from both parties, who sent a letter to Gov. Greg Abbott and HHS Commissioner Cecile Young opposing the change.

The removal of programs that have a proven record of excellent care is concerning, especially those that provide specialized services such as pediatric care. Driscoll, which serves South Texas, is one of three children’s healthcare systems dropped from the list; the others are the Cook Children’s Health Plan in North Texas and the Texas Children’s Health Plan, which serves the Houston area. A statement from the latter states that it’s the largest children’s healthcare system in the country, serving about 450,000 children and mothers.

Many families who utilize Driscoll might not be directly affected, as it strives to base medical costs according to patients’ ability to pay. Its ability to recoup some of those costs through Medicaid STAR and other programs enables it to serve more patients, ensure the best and most modern treatment and establish a presence where it is most needed, such as the new Edinburg center and its clinic in Brownsville.

But there are hidden costs. The lost funding also might affect research that provides benefits many people don’t see. Driscoll invests some $10 million each year into research on maternal fetal medicine. Smith says that investment has decreased maternal mortality, premature births and other complications in an area that historically has had an alarmingly high rate of such complications, and saved about $100 million per year in related medical expenses.

HHS has a poor record of handling these benefit programs. Most of the blame, however, has pointed to understaffing and poor records management. Reducing the number of clients won’t fix those problems; more likely, the fix will be worse than the problem.

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Nacogdoches Daily Sentinel. June 14, 2024.

Editorial: Heat and cars are deadly combination

As temperatures edge back into the mid 90s, it’s time to think about the impact heat can have in a closed vehicle — especially on children.

Leaving children alone in a car dangerous in the best of circumstances and in some cases illegal, even when heat is not a factor.

A variety of disaster scenarios easily could occur when children and vehicles are involved.

• A parent with too much on their mind in a quiet car might forget to drop off a sleeping baby with the child care provider.

• An open car or trunk could look like an ideal spot for hide-and-seek for a 5-year-old.

• Running into a store for “just a second” might seem harmless while a child buckled into his seat waits in the car.

All three situations potentially are deadly. Around 37 children die each year because of a deadly combination of heat and vehicles. Twenty-nine suffered fatal heat strokes in 2023, and two have already fallen victim this year, according to the National Safety Council.

A child who is left inside a car or is trapped while playing in a car can suffer heat exhaustion, heat stroke or death in only minutes.

Consider this: At 85 degrees the interior of a vehicle can reach 100 in around eight minutes. At 100, which we are currently nearing, the interior of a vehicle can hit 140 degrees or hotter in 15 minutes.

The third scenario, leaving a child in a running car, could lead to several possible outcomes, and possibly a criminal charge. The offense is committed when the child is left for more than five minutes, is younger than 7 years old and is not attended by a person 14 or older.

If the child gets hurt, the charge can become a felony of child endangerment and is punishable by six months to two years in jail and a fine of up to $10,000.

In an effort to protect children, and avoid potentially deadly situations, the Department of Family and Protective Services offered these tips:

• Never leave your car keys where children can get them.

• Keep car doors and trunks locked at all times, even in the garage or driveway.

• Teach children not to play in or around cars.

•Never leave your child unattended in a car, even if the windows are down and a windshield shade is in place or even just to run a quick errand.

• Make sure all children leave the vehicle when you reach your destination.

• Don’t overlook sleeping infants.

• If your child does get locked inside a car, get him or her out as soon as possible. If you can’t get him or her out yourself, call 911 or your local emergency number immediately.

Stay safe, and make sure your kids do too.

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