Here are some of the key issues and trends to keep an eye on in the realm of Texas Health and Human Services this legislative session.

First, a few notes about Health and Human Services (HHS) in Texas and why it's important to Texans.

• Lots of people: According to numbers from the HHSC Consolidated Budget for 2010-2011, there were at least 4 million Texans using some form of services or benefits provided by the Texas HHS enterprise in FY2009.
• Lots of money: According to the Texas Budget Source, Texas HHS spending accounts for the 2nd largest expenditure the state makes each biennium. Costs and caseload continue to increase at an alarming rate. Texas HHS agencies accounted for over 54,000 employees in FY09, thus incurring significant employee compensation and retirement liabilities.
• Lots of Federal influence: Adding to the budgetary challenges are the federal matching funds the federal government gives the state to administer these programs. In the Medicaid world, the Federal Medical Assistance Percentage (FMAP) dictates the percentage of every dollar spent in a given state that will be taken up by the federal government. In Texas, the FMAP is approximately 60% federal, 40% state. The match for the Children's Health Insurance Plan (CHIP) is approximately 75% federal, 25% state. Thus, the feds incentivize increased state HHS spending.

In short, HHS has a big impact on many people in Texas and the overall budget of Texas. Thus, it is a big cost driver to the state. With that in mind, here are a few trends to watch.

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