Austin at Large: Be Thankful for What We’ve Got

As we begin the Season of Excess this week, we are mindful that even though the world around us is going up in flames, we should name and claim what bits of goodness we can – some things in the news for which to be thankful. When you cover the slow and grinding wheels of local and state government as we do here at the Chronicle, it's always a cause for gratitude to see ambitious, complicated, and lengthy public initiatives bear some of the fruit for which they were planted. Here are some that did! Let us offer praise.

University Neighbor­hood Overlay (UNO)

Gather round the fire, wee ones, as Crazy Uncle MCM tells you a story of a long-ago zoning battle (it began in 2001) over the Villas on Guadalupe, also known at the time as the "Villas at Block­bust­er." (What is "Blockbuster," you ask? We'll tell that story later.) This predictable tumult over a five-story student apartment block, which was across the street from some houses, crystallized the unsustainability – some would say absurdity or even immorality – of limiting, through years' worth of policy and practice, the amount of housing for students within walking distance of the campus they attended. So we stopped doing that.

To be more precise, in return for firmer protections for the single-family neighborhoods then existing around campus – and thus a respite from playing whack-a-mole with every project that popped up at whatever site became available – those neighbors endorsed the planned transition of West Campus into the dense, urban neighborhood of today. For the moment, set aside your know-it-all cynicism from either side of the NIMBY/YIMBY street as to what Central Austin should have done instead, because back in the early 2000s, this was a pretty remarkable turn of events.

Earlier this month, the stakeholders that brought the UNO into being were able to secure city approval to literally take it to the next level – increasing heights within West Campus to make it more viable for builders to create more on-site affordable units to meet the needs of today's students (and whoever else wants to live in Austin's most functional big-city neighborhood). As we go through the same teeth-grindingly inevitable and interminable battles over density in Central Austin, with the revision of the Land Development Code, we often overlook this example right in our midst of how to create compact and connected neighborhoods that work for people without fulfilling naysayers' worst fears. Be thankful!

Central Health and Sendero Health Plans

Around the same time the UNO was born, Central Health came into being as the Travis County Hospital District; it's evolved since into the community's locally funded response to the failings of our broken national health care system, making access to care possible for hundreds of thousands of you and your neighbors. Instead of doing what its public-sector peers around the state do – collecting tax dollars to support care at a single charity hospital – Central Health has instead tried to take advantage of every means available to get more care to more people, from effectively taking over efforts the state has neglected in its stubborn refusal to expand Medicaid, to helping bankroll UT's Dell Medical School by purchasing its providers' services for low-income Austinites. (Crazy Uncle MCM worked as a consultant for Central Health, among others, when he was away from his desk at the Chronicle for a dozen years or so.)

One of those fill-the-gaps initiatives is Sendero Health Plans, where Central Health started a whole insurance company to participate in the state's managed care Medicaid and CHIP exchanges and then in the federal marketplace for the Affordable Care Act. This is a really big endeavor for a single public agency serving one county, no matter how awesome that county is, and it's not exactly shocking that Sendero has in its years of existence lost a lot of money.

Last year, as the scale of those losses grew to more than it appeared Central Health could bear, and as the agency faced community and political pressure to keep Sendero alive, its leaders embarked on yet another high-wire act: They would seek to move some of the sickest patients from Central Health's Medical Access Program over to Sendero. Normally, of course, this is the last thing an insurance company wants; but in this case, it allowed Sendero to increase the federal subsidy it received under the ACA. And it worked! This year, Sendero was able to continue to offer coverage to the thousands in Travis County, including artists and musicians as well as everyday working-class residents, because of this maneuver. For which we are thankful.

So let this be a challenge to you as we slide through the well-greased end of 2019 into the noisy steeplechase that will be 2020. When you get frustrated or hacked off at City Hall or Politics as Usual or even Those People, think for just a moment: What would it be like if we could actually make this stuff work the way it's supposed to? How would we be better off? It can happen!