Medicine Strategizes Best Uses for Federal COVID-19 Relief Dollars
By Emma Freer

The Texas Legislature likely will appropriate $15.8 billion from the federal American Rescue Plan Act (ARPA) during a third special session expected to be called in October – funds that physician leaders say could help ease pandemic challenges, such as clinical staff shortages, while also addressing emerging issues, such as research and treatment related to long COVID.

For now, the ARPA funding remains in a holding pattern: The federal government has allocated it to Texas, but that allocation awaits state lawmakers’ approval. When they reconvene, they will be tasked with deciding which priorities to fund.

State lawmakers have signaled their preference is for the federal relief dollars to go toward one-time initiatives rather than ongoing programs, making it more difficult to address some of medicine’s priority budget issues, including improving access to comprehensive health care coverage.

As a result, Texas Medical Association staff say they are working to identify initiatives that fit within lawmakers’ rubric while advancing some of physicians’ top policy goals.

For example, lawmakers could fund an outreach campaign to encourage low-income parents to enroll their uninsured children in Medicaid or the Children’s Health Insurance Program, thereby helping to reduce the state’s highest-in-the-nation uninsured rate, TMA Associate Vice President for Governmental Affairs Helen Kent Davis says.

Other potential legislative priorities include investments in electronic health record infrastructure, broadband expansion, and hospital clinical staffing.

TMA’s Council on Legislation also has proposed using ARPA funding to train primary care physicians in long COVID management and to cover the start-up costs for multidisciplinary clinics offering such treatment.

Such efforts would directly impact physicians and alleviate some of the financial and logistical consequences of the pandemic, TMA staff say.

Research suggests as many as 25% of patients diagnosed with COVID-19 develop one or more lingering symptoms, which may last for months, if not years.

Meanwhile, at least $1.2 billion in ARPA funding is already earmarked for certain health care priorities that may have more of an indirect impact on physicians, including COVID-19 testing in schools, vaccine distribution, community mental health services, and nursing home strike teams, according to the Texas Comptroller’s office.

With so much money on the table – ARPA funding amounts to more than 13% of the estimated general-purpose revenue in Texas’ 2022-23 budget – TMA President-Elect and Fort Worth pediatrician Gary Floyd, MD, says it’s an opportunity for state lawmakers to tackle long-standing issues, such as health coverage expansion and physician Medicaid payment increases.

TMA remains mindful, however, that lawmakers don’t want to tie the hands of future legislators with recurring costs.

“It’s a lot of money, but I do expect those deliberations to be challenging,” TMA Director of Legislative Affairs Michelle Romero said.

Last Updated On

August 23, 2021

Originally Published On

August 23, 2021

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Emma Freer


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Emma Freer is a reporter for Texas Medicine. She previously worked in local news, covering city politics, economic development, and public health. A native Clevelander, she graduated from Columbia Journalism School and the University of St. Andrews.

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