Frequently Asked Questions

Demand for access to vital healthcare services has been growing, with far more Travis County residents eligible for the MAP program than it has been funded to support. Instead of working with Ascension Seton to expand and properly fund MAP, Central Health has unilaterally overenrolled individuals into the healthcare program while refusing to provide funding to support care for these additional patients.

Ascension Seton has engaged in good-faith negotiation and mediation to resolve Central Health’s breach of the terms of our agreements. Unfortunately, those efforts were not successful, and we have now asked a court to intervene and direct Central Health to fulfill its obligation to pay the costs associated with the care it provides to the residents of Travis County.

It is now clear that Central Health has always intended to proceed to litigation as an excuse to spend the $400 million it has amassed from taxpayer funds to attempt to acquire Dell Seton Medical Center.

Central Health wants to own and operate Dell Seton Medical Center — a complex acute-care hospital affiliated with Dell Medical School at The University of Texas at Austin, and the only Level 1 trauma center in our region — at taxpayer expense, and without any demonstrated ability to do so. Central Health has no experience or capability to run a hospital, and this scheme would create an inequitable, two-tier healthcare system that would disadvantage both patients and Travis County taxpayers.

On May 2, 2023, Ascension Seton sent Central Health a notice of governance and funding deadlock in an effort to get Central Health back to the table to work collaboratively. It is our hope that new agreements can be reached with Central Health and that our public-private collaboration can continue, for the sake of both MAP patients and the taxpayers of Travis County.

Travis County will go back to the days of a two-tier hospital system: one public hospital for poor people and several high-end private hospitals for those who can afford it. And taxpayers will be left to foot the bill, rather than taking advantage of the expertise and infrastructure that is already in place today. This would disadvantage both patients and Travis County taxpayers.

Central Health has no experience or capability to run a hospital. Central Health should focus on its mission and not empire-building. The stakes and costs to the patients and taxpayers of Travis County are too high for Central Health’s experiment.

The Medical Access Program (MAP) is a health coverage program for uninsured Travis County residents.

Ascension Seton Medical Center serves as the safety net hospital for adults and children in Travis County. A safety net hospital serves all patients regardless of their ability to pay.

Since 2017, Ascension Seton has served as the “safety net” hospital system for Travis County, ensuring access to care for all residents regardless of insurance coverage and ability to pay. As part of our mission, we are committed to meeting this need for the community.

Our mission compelled us to take on this responsibility in the 1990s when the City of Austin needed a healthcare partner to maintain safety net services. Prior to that, residents were served for more than a century by a public hospital, known in its final years as University Medical Center Brackenridge. The financial, clinical and administrative challenges of operating a hospital led to the city’s decision to seek a partner.

Ascension Seton was willing to take on the financial risks associated with a safety net facility and began contracting the operation of Brackenridge in 1995.

For many years, the University of Texas at Galveston served as the graduate medical education (GME) program for Brackenridge Hospital. When the GME program was discontinued in 2005 after the devastation of Hurricane Rita, Seton evaluated how to create a strategy for a new medical school, teaching hospital and behavioral health services.

In 2012, Proposition 1 passed in Travis County — with 55% of the vote — to enact a 5-cent tax increase per $100 of assessed valuation that would create Dell Medical School at the University of Texas, with the help of $300 million from Ascension Seton. This partnership enabled the building of Dell Seton Medical Center at The University of Texas at Austin, a teaching hospital, provider of medical residencies and the only level one trauma center for an 11-county area. Proposition 1 also helped fund a redesign of the healthcare delivery system in Travis County and expand healthcare infrastructure and resources that serve uninsured residents.

In 2017, Brackenridge Hospital was closed and Dell Seton Medical Center became a new public safety net hospital serving Travis County. While Ascension has operated Seton Healthcare facilities since their inception, all the facilities were rebranded with the Ascension name in 2019. Ascension Texas operates Dell Seton Medical Center and more than 120 sites of care throughout Central Texas.

Through our safety net system that provides access to care for children and adults across Travis County, Ascension Seton continues to fulfill our mission of delivering compassionate care for all, with particular attention to the poor and vulnerable.

Through Ascension Seton charity care, our Mission to serve the poor and vulnerable in addition to the Medical Access Program (MAP) and our agreements with Central Health, Ascension Seton has effectively and efficiently served as a healthcare provider for the most economically vulnerable residents of Travis County. These services are part of the “safety net” system to help ensure disadvantaged populations receive vital healthcare regardless of insurance status and ability to pay. They are also central to Ascension’s mission to deliver compassionate, personalized care for all, especially those who need it most. Over time, our collaboration with Central Health has saved and improved thousands of lives by providing equitable access to healthcare throughout the community.

The public-private collaboration between Ascension Seton and Central Health saves money for Travis County taxpayers. Large healthcare districts across Texas require significantly higher taxes to support similar programs because they rely on public hospitals and clinics. Our collaboration helps bring efficiencies to Central Health operations and avoids duplication of many services by leveraging Ascension Seton’s existing facilities and clinicians.

Travis County residents pay taxes each year to fund Central Health’s mission, including arranging for services for residents enrolled in the MAP program. Because of the unique public-private collaboration that leverages Ascension Seton’s existing facilities and clinicians, Travis County taxpayers pay the lowest tax rate of other large healthcare districts across Texas.

Ascension Seton has proudly provided critical healthcare services for Travis County’s most vulnerable residents for 120 years as part of our mission to provide compassionate care for all and support the communities we serve.

For more than five years, Ascension Seton has engaged in negotiation and mediation to find resolution to Central Health’s breaches of the terms of our agreements. To continue to meet the needs of MAP participants, we have been forced to ask a court to intervene and direct Central Health to fulfill its obligation to pay the costs associated with that care.

We anticipate the legal process will result in Central Health once again meeting our shared commitment to serving Travis County’s most vulnerable.

Proper funding for MAP is readily available today. Central Health’s contingency reserves have multiplied tenfold over the past five years — currently sitting at well more than $400 million. These taxpayer dollars are supposed to support healthcare programs like MAP.

In addition, Central Health has failed to spend more than $100 million in funds that were budgeted to pay providers for expansion of hospital services for the poor and vulnerable.

In keeping with our mission, Ascension Seton has continued to provide equitable care for all MAP patients for the past several years despite Central Health’s financial shortfall, and we will continue to support MAP patients as the legal process proceeds. We are confident that the legal process will result in a solution that provides adequate funding for the MAP program moving forward.

Ascension Seton is committed to continuing to do our part to effectively provide services to more MAP patients. We need Central Health to engage in substantive discussions about sustainable solutions and take action to help ensure proper funding for services to the MAP patients moving forward. We anticipate the legal process will result in Central Health once again meeting our shared commitment to serving Travis County’s most vulnerable. On May 2, Ascension Seton sent Central Health a deadlock letter in an effort to get Central Health back to the table to work collaboratively.