Writing a two-year budget for a state as diverse, vast, and rapidly growing as Texas is never easy. During a global pandemic, it will be even harder. Not only will lawmakers face unpredictable economic crosswinds, but also higher need for state-funded services to support Texans affected by COVID-19.
During the legislative interim, the leadership tasked state agencies with reducing spending by 5%. Exempted from the cuts were essential and direct health care services. Now that budget writers have begun crafting the next budget, physicians urge lawmakers to continue to prioritize funding for health care services, workforce, public health, and social services.
By mid-2021, COVID-19 vaccines will help quell the pandemic, but its impact on Texans’ mental, emotional, and physical health will endure. Self-reported mental health and substance abuse problems have skyrocketed, as have suicides. Pandemic-induced job losses increased Texas’ already high rate of uninsured. And many Texans postponed or forewent vital preventive services, such as cancer screenings, and/or medically necessary treatment, which together will translate into higher rates of illness and death over the next several years.
Moreover, the pandemic highlighted longstanding disparities in health care access, coverage, and treatment – particularly among Texans of color or people who live in low-income rural or urban communities – that must be addressed.
Compounding these problems, COVID-19’s inexorable spread has strained physician practices, the health care safety net, the public health system, and the health care workforce. Many physician practices, particularly primary care, have laid off staff, reduced services, or even consolidated or closed – some permanently. Some physicians retired early. Yet even prior to the arrival of the virus, Texas’ physician workforce struggled to keep pace with demand.
State and local health departments have done yeoman’s work, while often contending with outdated equipment and too few staff. Safety net clinics struggle to manage growing ranks of uninsured.
Next session, money will be tight. Yet the state is well-positioned to respond to the crisis, having had the foresight to establish the Economic Stabilization Account (also known as the “Rainy Day Fund”), whose very purpose is to mitigate an unanticipated, enduring, and widespread economic shock as wrought by the pandemic.
TMA urges lawmakers to invest in the health of all Texans today and for future generations.
TMA's Legislative Recommendations:
- Insure more Texans with meaningful coverage by:
- Extending comprehensive health care coverage to low-income working-age adults;
- Providing postpartum women with a full year of Medicaid coverage;
- Establishing 12-months continuous coverage for children enrolled in Medicaid.
- Maintain funding for Medicaid, the Children’s Health Insurance Program (CHIP), women’s health services, and behavioral health services.
- Oppose reductions in Medicaid and CHIP physician payments.
- Reinvest any savings achieved via a comprehensive coverage initiative into value-based payment arrangements that reward physicians for improving health outcomes and lowering costs.
- Strengthen public health by streamlining and modernizing data systems and retaining critical staff.
- Improve the geographic distribution of physicians, enhance primary care access, and sustain investments in graduate medical education.