TMA Weighs in on Public Health, Medicaid Funding

Last week, TMA submitted comments regarding the 2016-17 legislative appropriations request from the Texas Health and Human Services Commission (HHSC) and the Texas Department of State Health Services (DSHS).

TMA encourages DSHS to invest in immunization services, chronic disease prevention, preventive care for low-income women, mental health services, and emergency preparedness.  

In regard to chronic disease prevention, TMA states, "We support DSHS' efforts to promote community-based initiatives to increase physical activity and access to healthy foods in Texas communities." The association adds, "DSHS has been successful in identifying many potentially preventable hospitalizations. If given appropriate resources, the agency could better foster community engagement to help reduce the many conditions related to chronic diseases, such as pneumonia, diabetes, and heart failure, all of which are endemic across Texas."

TMA's comments conclude: "We know DSHS faces a difficult task assigned by the Legislative Budget Board, especially when the state's public health system is at a breaking point. We would welcome the opportunity to further discuss any potential cuts and steps that might be taken to avoid such action and/or recommendation."

In the comments to HHSC, TMA urges the agency to prioritize improving Medicaid patients' access to services, including women's health care. The association specifically asks for support for maintaining the Medicaid primary care physician payment increase and for continued funding of the Texas Women's Health Program. 

Last session, the legislature provided $71.3 million for the Texas Women's Health Program, operated by HHSC. Ninety percent of the dollars replaced federal funding for the Medicaid women's health program, which Texas discontinued in 2012 because of its "affiliate ban rule," which excluded from the federal program clinics affiliated with abortion providers. The Texas program provides low-income women aged 18 to 44 with access to birth control, basic preventive health screenings, and treatment for sexually transmitted diseases. 

"While the investments made in the Texas Women's Health Program in 2013 increased the number of women served, tens of thousands of low-income Texas women still lack access to care. The state must work to maintain or increase the funding for this valuable program to help rebuild the women's health care safety net and ultimately save the state millions in Medicaid dollars," TMA said.

The Affordable Care Act authorized increasing Medicaid payments to Medicare parity for certain primary care physicians and services provided from Jan. 1, 2013, to Dec. 31, 2014.

"Without congressional action, the rate increase will cease at the end of this year. We urge the state to permanently extend the rate increase beyond Dec. 31, 2014. It is vitally important to increase the number of physicians participating in Medicaid so that access is not hindered and Texans can get the care that they need," TMA wrote.

The association also calls for an increase in Medicaid payments for physician specialties not included in the ACA primary care payment increase, including obstetrics and gynecology.

Action, July 1, 2014