Legislative Hotline Jan. 27: Texas’ 2022-23 Budget Proposals: What They Mean for Medicine
By Joey Berlin


Much of medicine’s hope for a healthy Texas rests on adequate funding for the programs and services the state needs. The Texas House and Senate have both unveiled their starting-point proposals for the 2022-23 budget, and the Texas Medical Association has been digging into the numbers to see what the proposals represent as a starting point for medicine.

Passing a balanced budget – which will ultimately be a Senate bill this year – is the only legislative action the Texas Legislature is required to take each session. In the coming weeks, the Senate Committee on Finance and House Committee on Appropriations will begin hearings on these respective bills, giving TMA opportunities to advocate on its budget priorities.

Below is a look at some of what’s in the two (largely similar) budget offerings.

Medicaid: Both versions provide for about $74 billion in Medicaid funding overall. Neither proposal includes an overall physician payment increase, although the House version would provide a 7% increase for services provided to patients 3 years old or younger.

Women’s health: Each budget version would provide $352.6 million for women’s health programs overall, an increase of about $5.6 million from the 2020-21 budget. That includes:

  • $238.9 million for the Healthy Texas Women (HTW) program, which provides women access to preventive and basic primary care, and HTW Plus, a new program to extend select specialty care services to postpartum women;
  • About $89.4 million for the Family Planning Program; and
  • $23.8 million for the breast and cervical cancer screening program.

Graduate medical education (GME) and physician pipeline programs: The Texas Higher Education Coordinating Board estimated that the budget would need $220 million in GME funding in order to maintain the state’s target ratio of 1.1 residency slots for every new medical school graduate. The House and Senate budget proposals – which are largely in lockstep with each other on GME funding – fall short of that mark, instead allocating $150 million to the GME Expansion Grant Program.

Both the House and Senate budget offerings include the following proposed funding breakdowns, all of which would be decreases from the 2020-21 budget:

  • $9.5 million for the Family Medicine Residency program, a decrease of 5%;
  • $2.85 million for the Primary Care Preceptorship Program, a 5% cut;
  • $9.7 million for the Joint Admission Medical Program, also a 5% decrease;
  • $45,006 per medical student per year (known as “formula funding”), a decrease of 1.6%; and
  • State GME formula funding of $11,359 per resident per biennium, a decrease of 4.9%.

The Senate and House proposals differ on funding for the Physician Education Loan Repayment Program: The Senate is proposing $29.5 million, a decrease of 1.3% from 2020-21; the House version proposes $28.9 million, a 3.2% decrease from the current budget.

Behavioral health: Both budgets provide about $8 billion for behavioral health across all state agencies. Of that, about $3 billion is allotted for adult and pediatric community-based care, crisis stabilization services, substance abuse treatment, and state hospital services, a modest increase from the 2020-21 budget.


Under the Rotunda


After a 12-day adjournment, the House and Senate briefly returned to the floor Tuesday afternoon. Following a quick convention of the House this morning, both chambers are now adjourned until Feb. 9. The only committee meeting this week is the Senate Special Committee on Redistricting. House committee assignments have not been announced. The Senate last week announced its committee assignments, which included chair roles for all three of its physician members.


Easy Ways to Get Involved in TMA Advocacy  

Last week’s kickoff of the 2021 legislative session brings new opportunities to get involved in TMA’s grassroots advocacy efforts at the Capitol.

Your participation is a vital component of our legislative success. Please help strengthen the voice of medicine by joining our advocacy efforts.

Stay up to date on TMA’s progress in the legislature. And take advantage of other opportunities to get involved with our advocacy efforts.

Last Updated On

January 27, 2021

Originally Published On

January 27, 2021

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Joey Berlin

Associate Editor

(512) 370-1393

Joey Berlin is associate editor of Texas Medicine. His previous work includes stints as a reporter and editor for various newspapers and publishing companies, and he’s covered everything from hard news to sports to workers’ compensation. Joey grew up in the Kansas City area and attended the University of Kansas. He lives in Austin.

More stories by Joey Berlin