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2023 Legislative Wrap-Up: TMA Secured Big Wins With a New Strategy
TMA Priority: Protect current vaccine laws and upgrade the state’s vaccine registry system to make it more user-friendly for practices.
Physician-Led Results: Texas physicians started this year’s legislative session with a simple strategy on vaccines: defend existing protections and push for a long-overdue technological upgrade to ImmTrac2, the state’s vaccination registry.
While the latter goal was overshadowed by efforts to undermine existing vaccine laws, the Texas Medical Association successfully fended off nearly 40 bills that threatened to erode access to routine childhood vaccinations or damage the state’s robust vaccine infrastructure.
“This session was about preventing the various bad things from happening,” said Keller pediatrician Jason Terk, MD, immediate past chair of the Texas Public Health Coalition, of which TMA is a member. Chief among them:
- House Bill 1105 by Rep. Four Price (R-Amarillo) and its companion, Senate Bill 749 by Sen. Pete Flores (R-Pleasanton), which would have allowed pharmacists to administer childhood vaccines; and
- House Bill 2079 by Rep. Jacey Jetton (R-Richmond), which would have allowed pharmacists to test and treat certain conditions – such as influenza, strep throat, and COVID-19 – by prescribing drugs.
Other vaccine-related wins that TMA supported include a $109 million increase in the state budget for disease prevention, epidemiology, and surveillance; and a $6 million increase for low-cost vaccinations for children and adults.
On the other hand, TMA advocacy helped mitigate the negative consequences of two vaccine-related bills that did pass and that Gov. Greg Abbott has signed into law.
In its original form, House Bill 44 by Rep. Valoree Swanson (R-Spring) would have kicked physicians out of Medicaid and the Children’s Health Insurance Program (CHIP) for having a “discriminatory” vaccination policy, such as deciding not to see unvaccinated patients. The amended version that ultimately passed allows practices to implement a vaccination policy but requires them to permit conscientious, religious, or medical exemptions similar to those seen in schools. The programs may refuse payment if physicians are found in violation of the law; however, physicians may seek administrative or judicial review if accused of noncompliance.
HB 44 is still “bad policy,” Dr. Terk says. It adds yet another regulatory layer to already burdensome programs, which could exacerbate access-to-care problems at a time when Medicaid and CHIP patients already have difficulty finding physicians available to care for them.
The Texas Health and Human Services Commission will have to write rules to implement the new law.
Meanwhile, Senate Bill 29 by Sen. Brian Birdwell (R-Granbury) followed Governor Abbott’s presession call to “end COVID restrictions forever.” It prohibits governmental entities from implementing mandates related to masks, vaccination, and closure of private businesses and schools because of COVID-19.
Physicians and public health advocates opposed this measure because one mutation of the COVID-19 virus could cause a resurgence in the pandemic, Dr. Terk says. However, TMA worked closely with Senator Birdwell to ensure the bill focused narrowly on COVID-19. It does not include any other vaccines or public health emergencies, nor does it include private entities like physician practices.
“We would not want this to be a first step toward further restrictions in the ability of public health officials to respond to emergencies,” Dr. Terk said.