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.

March 6 Hotline: TMA Calls On Lawmakers To Back Rural Track GME Expansion

(Medicaid, Public Health) Permanent link


The Texas Medical Association on Tuesday delivered testimony in support of graduate medical education (GME), maternal health, and preventing teenage nicotine addiction.

In the House Higher Education Committee, chaired by Rep. Chris Turner (D-Grand Prairie), Midland family physician Tim Benton, MD, delivered testimony representing TMA in support of House Bill 1065 by Rep. Trent Ashby (R-Lufkin).

HB 1065 would expand rural Texans’ access to care by creating a grant program for the development of rural training tracks to prepare physicians for practice in rural, underserved settings. It is of particular importance to Texas and TMA because the Medicare GME caps established in 1997 can be lifted for teaching hospitals that partner with medical schools to sponsor a rural training track.

Texas’ physician shortage is particularly acute in the state’s vast rural areas. Of Texas’ 177 rural counties, 101 are designated as “Primary Care Health Professional Shortage Areas.” Eighty-four rural Texas counties have five or fewer physicians; 24 counties have none, TMA reported in its Healthy Vision 2025 advocacy priorities. Ten rural Texas hospitals have closed permanently since the beginning of 2013.

“Research has shown that three out of four physicians who train in a rural track go on to practice in rural areas,” Dr. Benton said.

In the House Public Health Committee, TMA members testified in strong support of two bills, including House Bill 800 by Rep. Donna Howard (D-Austin), which would allow coverage under the Children’s Health Insurance Program for contraception if the enrolled child’s parent or guardian consents.

Austin family physician Celia Neavel, MD, noted that 20 percent of the 27,000 Texas teens who gave birth in 2017 already had a child.

“With parental consent, reducing barriers to contraception — including long-acting reversible contraceptives — helps guarantee fewer unplanned pregnancies and associated health risks, [and] abortions, and more education and greater economic opportunities for our patients,” Dr. Neavel told lawmakers.

The House and Senate both adjourned until Monday afternoon, but committee hearings continue through Thursday.

Eight full weeks into session — and just two days before the bill filing deadline — more than 5,000 bills have been filed. TMA is monitoring nearly 1,100 of them — in keeping with previous sessions’ rates of more than 20 percent of all bills filed.


Yesterday was TMA’s second First Tuesdays at the Capitol for the 2019 session. Hundreds of physicians, medical students, and TMA Alliance members swarmed the Capitol to speak with lawmakers and their staff about medicine’s priorities. Hot topics of conversation included scope of practice, health insurance reform, Medicaid payments to physicians, mental health, and public health. The next First Tuesdays is April 2. Register today

One important issue for TMA is raising the age to purchase tobacco and vaping products to 21 years. Yesterday, Dallas public health leader John Carlo, MD, led a press conference alongside Sen. Joan Huffman (R-Houston) and Rep. John Zerwas, MD (R-Richmond), the authors of Senate Bill 21 and House Bill 749, respectively, which seek to raise the legal age to purchase tobacco products. Earlier today, the House Public Health Committee heard testimony from Athens family physician and TMA President Doug Curran, MD, in strong support of HB 749

Yesterday, TMA co-authored an article in the Houston Chronicle with an urgent plea to Texas’ legislative leadership to renew the soon-to-expire 1115 Healthcare Transformation Waiver. If it expires, millions more Texas could be left without access to timely, quality, affordable health care, and Texas could lose $6 billion in annual federal funds. The plea came in conjunction with House Insurance Committee testimony from Dr. Curran in support of House Bill 565 by Rep. Garnet Coleman (D-Houston), which seeks to expand Medicaid coverage and protect patients with pre-existing conditions. 

Yesterday, Rep. Joe Deshotel (D-Beaumont) recognized TMA Board of Trustees member and Beaumont anesthesiologist Ray Callas, MD, with House Resolution 630. Dr. Callas was awarded the American Medical Association’s Medal of Valor for his efforts in the aftermath of Hurricane Harvey. Representative Zerwas co-authored HR 630, and all members of the House added their names in support. 


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 29 by Rep. Ina Minjarez (D-San Antonio) would allow patients to have direct access to physical therapists without a referral by a physician. The bill also would allow physical therapists to treat for up to 30 days a patient who doesn’t have a medical diagnosis or physician authorization for physical therapy. Senate Bill 732 by Sen. Bryan Hughes (R-Mineola) is the companion. TMA strongly opposes these bills. 
  • House Bill 1622, by Rep. Tom Oliverson, MD (R-Cypress) would permit physician dispensing of medications – but not controlled substances – provided at cost to the patient. These medications would largely be prepackaged, low-cost generics. TMA supports this bill. 
  • Senate Bill 305 by Sen. Kirk Watson (D-Austin) would protect from criminal charges the first person to request emergency assistance for someone overdosing when that person remains on scene and cooperates with medical and law enforcement personnel. TMA supports this bill. 
  • Senate Bill 340 by Senator Huffman would establish a grant program to fund access to opioid antagonists for law enforcement personnel. House Bill 1449 by Rep. Phil King (R-Weatherford) is the companion bill. TMA supports these bills. 


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.


When contacting your legislator, remember to be specific about the action you need, e.g., vote yes on HB10. Remember that every constituent contacting a legislator thinks his or her issue is the most important, so sharing facts or a memorable story as part of your communication will have more staying power than a simple action request. Get more tips in our Grassroots Advocacy Guide.


Today’s physician of the day is Larry Kravitz, MD, of Austin. Dr. Kravitz graduated from the George Washington University School of Medicine in Washington, DC, and is a member of both TMA and the Travis County Medical Society.


Should Texans be allowed to vote on Medicaid expansion? – Austin American-Statesman

Protections For Pre-Existing Conditions Joins Medicaid Expansion on Texans’ Healthcare Wishlist – Houston Public Media

Two dozen groups call for Medicaid expansion in Texas, which leads nation in uninsured – Houston Chronicle

Open Wounds, Head Injuries, Fever: Ailing Migrants Suffer at the Border – The New York Times

New bill would crack down on e-cigarette sales to Texas minors – KXAN-TV

Race and the Medical Profession: How Increased Diversity Could Influence the Way White Americans View Black Doctors – D CEO Healthcare

Instead of a surprise in the mail, costly ER bills could be sent straight to mediation in Texas – Austin Business Journal