Overview
For medicine, one word characterized the
start of the 78th Texas Legislature - anxiety. Organized medicine
had an ambitious, complex agenda, ranging from much-needed
professional liability reform to workable prompt pay standards to
maintaining health care coverage for hundreds of thousands of
poor and low-income patients. The Texas Medical Association
worked diligently throughout the 18 months preceding the session
to build support for its varied and important legislative goals,
working hand in glove with county medical and specialty societies
to educate legislators about the issues at stake. Yet, despite
all the preparation, two factors presented a considerable
challenge to realizing medicine's initiatives: new legislative
leadership, including a new speaker of the house, new lieutenant
governor, and more than 25 freshman members, and the biggest
budget deficit in more than a decade.
Just as legislators settled into their
desks, the comptroller of public accounts announced that an
expected $5 billion budget deficit had ballooned to $10 billion.
The announcement cast a long shadow over every issue confronting
the legislature, even those not related directly to an
appropriation, since the deficit meant more legislative
horse-trading than usual to accomplish legislators' - and their
constituents' - goals. Grassroots advocacy assured that TMA
started off on the right foot with the new legislators, yet, as
is expected with new relationships, each side had a lot to learn
about the other.
In spite of the challenges, medicine accomplished what it set
out to do on four of TMA's five top priority issues: enact
meaningful professional liability reform; require logical, timely
prompt pay standards; improve education about and availability of
childhood vaccinations; and prevent nonphysicians from practicing
medicine.
Only health care funding fell short, although TMA advocacy did
avert the most draconian budget proposals considered by the
legislature, including a 33-percent Medicaid physician rate
reduction. TMA will continue working during the next three to six
months to convince the legislature to allocate unspent state and
federal dollars for restoring the health care cuts.
On another major priority, workers'
compensation reform, TMA was unable to enact a statutory fix to
the impending payment reductions. (A legal challenge is still in
process.) However, the association did block implementation of an
ill-conceived, employer-directed network bill that would have
jeopardized patient access to care and obliterated the workers'
compensation physician network.
In addition to tracking bills related to
TMA's top five priorities, the association followed more than 800
bills that impacted patient care and the practice of medicine.
This legislative compendium describes the bills that passed, the
near misses, and the bills TMA helped to defeat. Bills that TMA
backed but did not make the final cut are described along with
the political context in which they dissolved. The information
below also describes how new legislation is likely to impact
physician practices, the regulatory and legal activities
regarding its implementation, and the activities already underway
at TMA to assure medicine achieves its 2005 legislative
goals.
To maintain TMA's credibility and success
in the legislature, the Board of Trustees, Council on
Legislation, and other policy bodies within the association
already are preparing for the 2005 legislative season. TMA's
postsession plan includes active engagement of grassroots
physicians in local meetings and educational forums with
legislators; participation in the election cycle through TEXPAC,
TMA's political action committee; assessment of nascent physician
issues through member surveys; participation in legislative
interim studies; and formation of internal TMA policy groups to
develop legislative recommendations on key issues facing patients
and physicians.
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