TMA Legislative Hotline

Hotline is a daily electronic newsletter exclusively for TMA members that reports the legislature's latest actions on bills affecting Texas medicine.

TMA Legislative Hotline: Physicians Issue Call to Raise Tobacco Sale Age

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In a busy start to the week, Texas physicians on Monday urged lawmakers to raise the age to purchase tobacco and vape products to 21, to provide liability coverage for physicians who volunteer during a disaster, and to protect all children from sexual abuse.

Dallas public health and preventive medicine physician John Carlo, MD, spoke to the Senate State Affairs Committee in favor of Senate Bill 21 by Sen. Joan Huffman (R-Houston), which seeks to increase the minimum age for purchasing tobacco and vape products to 21.

The data Dr. Carlo presented told a shocking story, including the fact that two-thirds of Texas 10th-graders and nearly half of eighth-grade students say it’s easy to get cigarettes from older friends and peers. SB 21 seeks to prevent youth access to tobacco and vape products by lowering the likelihood of them being in the same social networks as those who can purchase tobacco and vape products legally.

“We’ve known for almost four decades how the tobacco industry considers ‘today’s teenagers’ to be ‘tomorrow’s potential regular customer,’” Dr. Carlo told lawmakers. “We as physicians urge this committee to keep our kids today from being tomorrow’s tobacco death statistic.”

Meanwhile, in the House Judiciary and Civil Jurisprudence Committee, Houston psychiatrist George Santos, MD, testified in support of House Bill 1353 by Rep. Tom Oliverson, MD (R-Cypress), which would provide liability protections for physicians who volunteer in the aftermath of disasters.

Dr. Santos told lawmakers that during Hurricane Harvey, the emergency shelter at Houston’s NRG Stadium required the assistance of 450 physicians to treat approximately 7,000 patients.

“One of the biggest challenges in operating a mass shelter clinic for four weeks was the ability to keep our shifts staffed with medical professionals of all sorts,” Dr. Santos said. “One of the ongoing concerns was exposure to liability risks.”

Earlier this month, TMA testified in committee in support of Senate Bill 752 by Senator Huffman, the companion bill to HB 1353. SB 752 could possibly be debated by the full Senate today.

And the House Criminal Jurisprudence Committee took testimony on House Bill 85 by Rep. Mary Gonzales (D-Clint), would eliminate a discriminatory and burdensome mandate that jeopardizes the patient-physician relationship with adolescents. Currently, physicians are not required to report sexual activity between minors of the opposite sex as long as the age range doesn’t exceed three years, however that does not apply to sexual activity of same-sex minors. HB 85 would extend the existing affirmative defense of indecency with a child to same-sex relationships.

Austin pediatrician Celia Neavel, MD, described the quandary she now faces when treating LGBTQ-plus patients, saying, “Do I provide the same compassionate, understanding care to my LGBTQ+ patients as I do to my heterosexual patients, but then have to report the youth to Child Protective Services? The former is my ethical responsibility as a physician; the latter is my obligation under state law.”

All three of these bills were left pending in committee and will be voted on at a later time.


With a flurry of activity, the bill filing deadline finally passed, and lawmakers filed 7,499 bills. TMA is monitoring 1,908 of them, although that will likely change. Bills must be referred to committee before they can be heard on the floor and voted on by the full body. Then the process repeats in the other chamber. Bill referral should be complete this week. Seventy-four days remain in this session.


This list will change frequently during the session, but here are some bills TMA is watching now. Keep an eye on your email inbox for Action Alerts as we work to pass or kill bills. 

  • House Bill 1585 by Representative Gonzalez (D-Clint) would require the Health and Human Services Commission to prepare a report on wait lists for people with intellectual and developmental disabilities, and strategies to eliminate the wait lists. TMA supports this bill. 
  • House Bill 937 by Rep. Sarah Davis (R-West University Place) would require Medicaid to cover a full 12 months’ supply of contraception. TMA supports this bill.  


Healthy Vision 2025 – released in late January – is TMA’s all-inclusive, health care roadmap for legislators.

Want to help spread and promote TMA’s Healthy Vision for Texas? Become a TMA social media ambassador.


Motivation for contacting your legislator may stem from frustration about a particular issue, so take care to remember to be diplomatic in communications with your legislators and/or their staff. Don’t begin your conversation by saying, “As a citizen and taxpayer…” Don’t be argumentative or abrasive. And don’t ignore your legislator, then contact a legislator from another district for help with your issue. Get more tips in our Grassroots Advocacy Guide.


Today’s physician of the day is Sylvia Garcia-Beach, MD, of Dripping Springs. Dr. Garcia-Beach graduated from the University of Illinois College of Medicine, and is a member of both TMA and the Travis County Medical Society.


Bill to raise smoking age to 21 in Texas gets first hearing today – Houston Chronicle

There are more Texas medical schools than ever, but are there enough residencies to train them? – San Antonio Express-News

Death By A Thousand Clicks – Kaiser Health News, Fortune

Our view: Texas must do better for children with disabilities – Lubbock Avalanche-Journal

Texas Is One Of Only 14 States That Haven’t Expanded Medicaid – Despite Strong Public Support – KUT

Our view: Vaccination rate transparency good idea for public schools – Amarillo Globe-News

Walk with a Doc program to begin Thursday; walks to cover topics including mental health, how to live to 100 – Tyler Morning Telegraph