TMA Hotline: Improve Medicaid Payment to Improve Access and Coverage
By Jennifer Perkins



The final 2020-21 state budget won’t be decided for some time, but the heavy lifting of asking for funding is well under way. Yesterday, the House Appropriations Subcommittee on Article II (which covers health and human services) heard several hours of testimony, including an impassioned plea by Texas Medical Association President Doug Curran, MD, a family physician from Athens.

Chief among Dr. Curran’s priorities was revitalizing the Medicaid and CHIP physician networks by increasing payments for all primary and specialty care physicians.

Improving Medicaid and CHIP payment rates, which have stagnated for decades, will incentivize more physicians to participate in those networks, which in turn will improve access to care for Texas’ most vulnerable patients. But it won’t be easy, Dr. Curran said.

“Our organizations acknowledge that this is a significant request. At the same time, physicians – key partners in the state’s efforts to constrain Medicaid costs – are at a breaking point,” he testified. “Medicaid payments are the least competitive among all insurers, paying from only 40 to 87 percent of Medicare and 41 to 73 percent of commercial insurance rates.”

Without network participants, a Medicaid card is just something to carry in your wallet. It does not guarantee access to care, Dr. Curran said.

Dr. Curran also urged budget writers to promote better birth outcomes by providing comprehensive health care coverage to low-income women before, during, and after pregnancy.

“We can make dramatic gains in maternal health outcomes, but the legislature must ensure that women have access to preventive, primary, and specialty care before and after pregnancy,” Dr. Curran said in reference to House Bill 1110 by Rep. Sarah Davis (R-West University Place), which proposes extending Medicaid coverage for postpartum women to 12 months, up from the current two months.

Four weeks into session, bill filing is not slowing as the March 8 filing deadline nears. The current count is almost 2,500 bills filed. TMA is monitoring more than 530 of them – in keeping with previous sessions’ rates of more than 20 percent of all bills filed. Just under 30 days remain for bills to be filed. The House yesterday began referring bills to committee.


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

  • Senate Bill 338/House Bill 749, by Sen. Joan Huffman (R-Houston) and Rep. John Zerwas, MD (R-Richmond) respectively, raise the age for sale of tobacco and e-cigarette products to 21. 
  • Senate Bill 329 by Sen. Kel Seliger (R-Amarillo), also known as the Parent’s Right to Know bill, grants parents and guardians access to de-identified immunization data for their child’s school. 
  • Senate Bill 310 by Sen. Jose Rodriguez (D-El Paso) permits co-agents on medical powers of attorney. TMA opposes this bill. 
  • Senate Bill 580 by Sen. Donna Campbell, MD (R-New Braunfels) prohibits nonmedical switching of drugs by health plans. 


Healthy Vision 2025 – released late last month – 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.


Nothing drives home the importance of an issue like a personal story. When calling or writing your legislators, tell them specifically how the issue affects you, your colleagues, and patients. (Students can offer credible anecdotes from their own medical school experiences.) This is the best way to persuade lawmakers that what may seem like an abstract or arcane point really affects their constituents deeply. Get more tips in our Grassroots Advocacy Guide.


If talk of bills and committees and backroom deals initiate tachycardia, you might want to join TMA Leading Advocates. It’s TMA’s exclusive Facebook group for legislative advocacy. Enjoy special features, news in advance, and a community of TMA members who are excited to talk about the Texas Legislature and medicine's advocacy priorities. This closed group is open only to TMA and TMA Alliance members, and TMA and county medical society staff. Join today.


TMA’s 2019 legislative agenda includes priorities to help advance patient care in Texas.

Top on the list are the state budget, insurance reform, scope of practice, maternal health, the Texas Medical Board and Medical Practice Act, and public health.

TMA member physicians and medical students, and TMA Alliance members play a significant role in advancing medicine’s priorities at the Capitol. Here are some ways you can help:

  • Register for First Tuesdays at the Capitol – there are three left;
  • Testify before a House or Senate committee;
  • Learn more about TEXPAC, TMA’s bipartisan political action committee;
  • When called to do so, respond to Grassroots Action Center alerts on specific bills via our new VoterVoice app; and/or
  • Make sure you receive TMA’s Legislative News Hotline each day, via Texas Medicine Today. Here’s how: Just log in to the Edit My Interests page on your TMA profile. Ensure you get all the legislative updates by selecting "Health care issues in the Texas Legislature" as one of your Grassroots and Advocacy interests. TMA’s updates on the latest bills affecting medicine will arrive in your inbox as part of Texas Medicine Today at 2 pm each day lawmakers convene at the Capitol throughout Texas’ 86th legislative session.


Physician of the Day is a service the Texas Academy of Family Physicians (TAFP) provides the Texas Legislature. Each day the legislators are in session, the group names a physician to serve in the Capitol. This tradition started in 1971 and has continued every legislative session since, including special sessions.

Today’s physician of the day is Anuj Sharma, MD, of Austin. Dr. Sharma graduated from the University of North Carolina School of Medicine and is a member of the Williamson County Medical Society.


7 mumps cases confirmed at Houston ICE Facility – KHOU-TV

Texas MDs Hopeful Legislature Will Fund Diverse Public Health Initiatives – WOAI Radio

ROBERTS: We need Tobacco 21 Legislation now [Opinion – Op Ed] – The Lufkin Daily News

Measles cases a sign that Texas is risking a public health calamity [Opinion – Editorial] – Houston Chronicle

School Shooters: What’s Their Path To Violence? – NPR

Depression 101: Dallas Schoolkids Learn About Mental Health – The Associated Press

Time to remove Texas’ drug middlemen [Opinion – Op Ed] – San Antonio Express-News

Last Updated On

February 13, 2019

Originally Published On

February 12, 2019

Related Content

Texas legislation