Texas physicians need to lobby state and federal lawmakers as soon as possible to prevent cuts in important state services, to encourage the expansion of Medicaid, and to preserve gains made in telemedicine, a panel of speakers told participants in a telephone town hall sponsored Thursday by the Texas Medical Association’s Border Health Caucus.
The COVID-19 pandemic coupled with sharp drops in oil prices have slowed the state’s economy and caused drastic shortfalls in the state budget, state Rep. Cesar Blanco (D-El Paso) told border-area physicians who participated in the call. Comptroller Glenn Hegar has projected a $4.6 billion shortfall, and Texas Gov. Greg Abbott already has asked state agencies for 5% budget cuts, Representative Blanco pointed out.
As a result, agencies are proposing cuts in health care programs for women and children as well as cuts to food banks and other services that directly affect the health of patients, he said.
Although some state lawmakers – like him – favor using money from the state’s $8.5 billion “Rainy Day” reserve fund to make up budget shortfalls in important services, not all legislators do.
“We’re really going to need your guidance about how to approach these issues,” he said.
Representative Blanco was joined in the tele-town hall by TMA President Diana Fite, MD; TMA President-elect Linda Villarreal, MD; Luis Urrea, MD, chair of the Border Health Caucus; Victor Gonzalez, MD, vice-chair of the Border Health Caucus; Luis Benavides, MD, past chair of the Border Health Caucus; and Martha Vela Acosta, MD, a member of the U.S.-Mexico Border Health Commission.
Both Representative Blanco and Dr. Fite called on physicians to champion the expansion of Medicaid with state lawmakers. Because of the pandemic and its economic fallout, the state’s percentage of people without health insurance – already the highest in the country – has grown sharply, Dr. Fite said.
“The statewide amount is about 18.4%, but on the border it’s more along the lines of 29%,” she said.
The 18.4% rate was calculated before the pandemic and is going to increase, she predicted.
“At this point, we just have to have [Medicaid] expansion,” Dr. Fite said. “TMA has written a letter to the governor signed by me as president and 33 other specialty societies and similar groups asking, ‘Could we please, with COVID making things even worse, consider some form of expansion?’”
Expansion would provide coverage for an estimated 1 million or more people in Texas, Dr. Fite said. Though Governor Abbott and Lt. Gov. Dan Patrick have opposed Medicaid expansion in the past “they seem open to at least listening to options,” she said.
TMA estimates Medicaid expansion would bring in more federal dollars to the program and save Texas $110 million per biennial budget, Dr. Fite says.
The tele-town hall also focused on telemedicine. In March, Governor Abbott issued a series of temporary waivers that allowed physicians to be paid for telemedicine visits in same way they have traditionally been paid for office visits. Likewise, temporary changes in federal policy prompted by the pandemic became key in the widespread use of telemedicine, Dr. Villarreal said.
“Now we have trained our patients and our physicians to use an additional tool – telemedicine,” Dr. Villarreal said. “We need to send the message to Congress [and state lawmakers] that what they have started through a temporary waiver needs to continue permanently.”
Physicians participating in the event also answered a poll question: What issue is most important to the viability of your practice?
- 32% said telemedicine and payment parity;
- 28% said Medicaid physician payments;
- 18% said Medicaid coverage expansion;
- 17% said liability protections; and
- 5% said administrative simplification and reform in Medicaid managed care organizations.
Thursday’s tele-town hall was the latest in a series of six town halls held by TMA since March, two of them on border-related issues. Also, the Border Health Caucus and border-area county medical societies have held five virtual events since June. Learn more on the Border Health Caucus webpage.
Stay up to date with the latest news, resources, and government guidance on the coronavirus outbreak by visiting TMA’s COVID-19 Resource Center regularly.