The 10 men and women charged with negotiating the final shape of the state’s 2020-21 budget have received a powerful message from Texas physicians: A strong Texas depends on significant and continuous investments in health care.
“Healthy Texans underpin Texas’ economic health,” the Texas Medical Association and specialty societies representing pediatricians, family physicians, obstetrician/gynecologists, internists, and psychiatrists wrote in a detailed six-page memo to the members of the Senate-House conference committee on the budget. “We respectfully call upon you to adopt a bold, patient-centered legislative agenda.”
TMA is urging physicians, medical students, and alliance members who are constituents of the 10 conference committee members to reinforce medicine’s message with telephone calls, emails, letters, and personal visits of their own.
The draft budget bills that have passed both chambers of the legislature this year, the groups wrote, “largely shortchange the millions of Texans” who are uninsured, who depend on Medicaid, or who recently delivered a baby. We write to urge you to make the budget better – much better.”
A $500 million infusion of new state dollars into physicians’ Medicaid payment rates is a top priority for TMA and the specialty societies.
“Texas Medicaid’s physician fee-for-service payment rates – which are what most Medicaid managed care organizations pay physicians – have not received a meaningful, enduring increase in more than two decades,” they wrote. “Physicians – who are key partners in the state’s efforts to constrain Medicaid costs – are at a breaking point. Medicaid payments are the least competitive among all insurers.”
Rather than across-the-board rate increases, the groups asked the lawmakers to direct the state to convene a Medicaid/CHIP Physician-Payment Advisory Committee to advise on how best to distribute the funds to:
- “Reward innovative, value-based health care delivery models;
- “Maximize the state’s efforts to improve Medicaid patient health outcomes;
- “Constrain cost growth and address key health care challenges, including initiatives to improve maternal and child health;
- “Increase the availability of mental health and substance use disorder treatment; and
- “Strengthen rural, border, and underserved physician networks.”
The groups’ letter also includes calls for the conference committee to:
- Boost funding for Healthy Texas Women and the Family Planning Program to ensure all eligible women can obtain necessary preventive health services.
- Provide 12 months’ comprehensive coverage to postpartum women who lose pregnancy-related Medicaid.
- Reject a Senate proposal to “wring another $350 million” in state funds ($900 million total) from the Medicaid program.
- Improve Texas’ vital records and state public health data.
- Strengthen the state’s public health laboratory.
- Boost Texas’ public mental health system to promote early detection and treatment of mental illness and substance abuse disorders.
- Increase funding for, or avoid cuts to, graduate medical education, rural physician training, the Physician Education Loan Repayment Program, and several primary care training programs.
The House of Representatives passed its $251 billion version of the budget bill on March 28. The Senate adopted its $248 billion plan on April 9. The 10 conference committee members – led by House Appropriations Committee Chair John Zerwas, MD (R-Richmond), and Senate Finance Committee Chair Jane Nelson (R-Flower Mound), have until the legislative session ends May 27 to craft a final budget that can win majority support in both chambers.