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Hays County explores creating healthcare district to expand coverage, but commissioners seek more details
Summary
Staff presented a proposal to study and potentially create a Hays County health district to expand coverage and maximize Medicaid reimbursements; commissioners asked for feasibility numbers, stakeholder input and clearer cost estimates before proceeding.
Jacob Lamone, representing Judge Becerra’s office, presented a conceptual roadmap for a county health district intended to expand access beyond indigent care, stabilize funding using a possible local levy and to maximize Medicaid reimbursement under an 1115 waiver. Lamone said the county currently budgets roughly $2 million for indigent care and that partner hospitals have carried substantial uncompensated costs; one report cited losses up to $30 million over time by local partners.
Commissioners asked for additional financial detail, risk assessments and stakeholder work. Commissioner Smith and others warned of county health‑district failures in other parts of Texas and potential tax impacts; Commissioner Hammer urged a feasibility study and clearer projections about levy rates and contractual obligations. Jacob and staff said next steps would include a feasibility study, stakeholder committee and drafting an intent document if the court elects to proceed.
