John D. “Jack” Myers, MD, recalls when in 2024, his House representative in Bell County, Rep. Hugh Shine, lost a Republican primary challenge to then-candidate and now Rep. Hillary Hickland (R-Belton). The incumbent had a good relationship with the Texas Medical Association and had secured the endorsement of TEXPAC, the bipartisan political committee established by the association.
Then, in personally meeting Representative Hickland, Dr. Myers, who currently serves as TEXPAC’s Candidate Evaluation Committee (CEC) chair and will become TEXPAC chair in the fall, learned that her father and husband are both physicians. After conducting a thorough candidate evaluation process, TEXPAC decided to shift its support to the new winner and supported her in a successful 2024 general election.
“Now she’s one of our biggest advocates to help with the House of Medicine,” the Temple internist told Texas Medicine. She allied with medicine in the 2025 session on issues like scope of practice expansion and physician workforce development.
In the state primary this past March, TEXPAC’s grassroots approach – which relies on physicians like Dr. Myers getting to know the Texas House and Senate candidates in their districts to help inform the endorsement process – resulted in successful campaigns across the political spectrum to boost medicine’s sway in the Texas Legislature. That included support for five physician candidates, many of whom have been long-time allies of medicine.
• Sen. Charles Schwertner, MD (R-Georgetown), who has helped physicians on scope of practice and insurance issues.
• Rep. Suleman Lalani, MD (D-Sugar Land), who has been an ally for medicine on education and workforce;
• Rep. Greg Bonnen, MD (R-Friendswood), who has been instrumental in addressing prior authorization issues through championing gold card legislation;
• Rep. Tom Oliverson, MD (R-Cypress), who has been especially engaged with physician workforce development; and
• G. Ray Callas, MD, who would add to physician ranks in the legislature, and as TMA president was especially tough on scope of practice.
In the March primary, candidates backed by TEXPAC had an overall 92% success rate, with 100% in the Senate. In the 2024 election cycle, TEXPAC backed 140 candidates in general election races for U.S. Congress, the Texas House, and the Texas Senate – and 139 of them won.
But to keep that record strong, and keep pace with medicine’s opponents, TEXPAC must grow its ranks and remain agile, says Andrew “Jimmy” Widmer, MD, a former TEXPAC chair and CEC chair.
“We are constantly outfundraised and outspent when it comes to campaigns and races,” the Frisco internist told Texas Medicine. “We need to do a better job of supporting TEXPAC and supporting these candidates, because while it’s important that we pass good policy in the House of Delegates, if we don’t have elected officials who we can talk to, who understand our issues and can help us to turn those policies into legislation at the Capitol, then we’re not as effective as we can and should be.”
Just 8% of TMA physicians are TEXPAC members, and when considering TMA Alliance and association members together, that shrinks to less than 6%. TMA medical students and residents are also eligible to join TEXPAC, but only a fraction of a percent of both groups are represented among its ranks.
And while those who participated helped TEXPAC raise nearly $1.7 million in 2024, that pales in comparison to other Texas political action committees raising twice or more that amount. If every TMA and TMA Alliance member joined TEXPAC at the basic level, it would generate more than $3.6 million, putting it on more even footing with larger Texas PACs, calculates Director of TEXPAC and Political Education Brianna Menard. (See “TEXPAC by the Numbers,” page 24.)
This year, TMA is also establishing a new PAC to focus exclusively on supporting state and local candidates aligned with TMA’s positions on its No. 1 legislative issue: scope of practice.
Dr. Widmer points out that Texas’ physician lawmakers – Sen. Donna Campbell, MD (R-New Braunfels), Representative Bonnen, Representative Lalani, Representative Oliverson, and Senator Schwertner, who have garnered long-time TEXPAC support – have been constant pro-medicine legislators with a combined 60 years of service in state offices.
“It’s impossible for most [legislators] to have a good, deep understanding of so many of our complex issues,” he said. “So, it’s important to have those local relationships with members, and to identify candidates who we can work with over the years, to not only help to elect, but then educate them on our issues, starting with physician-legislators on both sides of the aisle and in both chambers.”
TEXPAC’s detailed, candidate evaluation process starts with a bottom-up approach.
The four-step process involves:
1. Physician Support: TEXPAC staff encourages candidates to connect with physicians in their district or county and ask for their recommendation for endorsement to the TEXPAC CEC. Physicians may submit these recommendations by email or mail, and TEXPAC staff compile them for review by the CEC.
2. County Medical Societies: When available, a district’s county medical society (CMS) interviews candidates to assess their positions on issues affecting medicine. The CMS executive director then forwards member feedback to TEXPAC. Any recommendation for endorsement is submitted to the CEC for further discussion and consideration.
3. The TEXPAC Candidate Evaluation Committee: The CEC reviews recommendations from CMSes and feedback from local physicians. It votes on whether to forward endorsement recommendations to the TEXPAC board. For incumbents seeking support, the CEC evaluates their voting record against TMA positions, requiring at least an 80% score and considering collaboration with organized medicine.
4.TEXPAC Board of Directors: The board of TEXPAC reviews the slate of candidate endorsements recommended by the CEC and votes to determine TEXPAC’s final slate of candidate endorsement, which is then announced.
“TEXPAC has been really grassroots, which I think is a great way to do it,” said Sara Austin, MD, another former TEXPAC Executive Committee chair, recalling that during this March’s primary, open races allowed her and other Travis County Medical Society members to meet and interview candidates to get a sense of who to recommend.
“We interviewed three candidates in one night, and you really get a feel for how they feel about medicine,” the Austin neurologist told Texas Medicine. “Then we turn around and make a recommendation to TEXPAC, and TEXPAC definitely takes that into account.”
In addition to physician wins this primary, TEXPAC support helped medicine-friendly candidates in key committee positions preserve their seats, such as on the House Public Health and Appropriations Committees.
And with significant turnover expected in the legislature, maintaining strong relationships with experienced Senate allies – where TEXPAC had 100% success in the primary – will be critical going forward, Ms. Menard says.
Dr. Callas has been on both sides of the TEXPAC equation. He served on the CEC before joining TEXPAC’s Board of Trustees, and, in this most recent primary election cycle, secured a TEXPAC endorsement early in his candidacy.
Though he considers himself an expert on a number of the issues concerning medicine, such as scope of practice expansion, balance billing, and the No Surprises Act, he’d relied on his colleagues in TMA on issues like insurance and vaccines. In shifting from a physician advocate to a legislative candidate, he determined he needed to prepare for the rigors of the TEXPAC endorsement process.
“I did a lot of reading,” he told Texas Medicine. “I listened to a lot of people talk to me about it, and more importantly, I have good people on my team that have been helping me along the way.”
During his time on the CEC, despite identifying himself as a “strong conservative,” he advocated for Democrats and independents, citing Rep. Nicole Collier (D-Dallas) and Rep. Oscar Longoria (D-Peñitas) as examples of current medicine-friendly House members he’s proud to support and could be working with as a future legislator.
“As long as they were in line and they represented TMA’s interests and positions, I would not be scared to cross-pollinate, so to speak, to get them endorsed,” he added.
But those endorsements don’t mean much without financial support to get them into office, he says.
“That was the engine behind this locomotive ... I had strength financially,” Dr. Callas said of TEXPAC’s support. “Once I got [the PAC] on my team, that really improved my momentum.”
Though he ran unopposed, Dr. Callas’ campaign garnered one of the highest voter turnouts in the state primary, support that could prove beneficial in the future.
While some physicians might be reluctant to engage in politics, Dr. Austin says it’s an important investment to make in continuing to practice how they want.
“For some people, they feel like it’s unsavory to get involved in the money aspect of politics, [saying] politics shouldn’t be about money. Well, politics is about money,” she said. “It costs an enormous amount of money to run a campaign. People that want to run a campaign have to have money. They have to make that money somehow, so this is the way that we help those people that are helpful to the House of Medicine. It’s the way we help them get into office.”
With tough fights ahead in 2027 legislature, medicine will need widespread political support to keep pace. In particular, scope of practice is shaping up again to be medicine’s top issue, and TMA is poised to debut SCOPE PAC, which will focus on supporting state and local candidates aligned with TMA’s positions on scope of practice and patient safety issues.
“The ugly fight of scope of practice expansion is just getting started,” Ms. Menard said. Referring to nurse practitioner groups in particular, she added, “They got so close through so many different paths to winning last legislative session, and they’re just going to be hungrier.”
Clayton Stewart, TMA’s vice president of public affairs and chief lobbyist, says having a political action committee dedicated to that issue could motivate donors to additionally help medicine-friendly candidates.
“It’s really about the sanctity of the practice of medicine,” Mr. Stewart said. “But beyond the sanctity of the practice of medicine, I think what we’re also dealing with here is a massive patient safety issue.”
He also sees SCOPE PAC board positions as places to provide “an opportunity to get some younger physicians involved,” especially those who are looking to develop as TMA leaders.
The initial fundraising goal for SCOPE PAC is to see how quickly it can get to the $100,000 benchmark while continuing TEXPAC fundraising efforts.
TEXPAC memberships start at the $99 level for physicians, with lower entry-level tiers for medical students ($10), residents ($40), and TMA Alliance members ($55). Additional member benefits begin with the 300 Club, as TEXPAC holds receptions for members at that level ($300 for physicians, $60 for medical students and residents) with elected officials also in attendance.
Because medicine’s issues like scope of practice and insurance battles aren’t going away any time soon, and because of the frequency of Texas House races in particular, Dr. Austin says that it’s important for TEXPAC contributors to commit beyond just one-time donations. But even basic memberships can make a difference.
“A little bit from a lot of people goes a long way,” she said.
Texas Medical Association Political Action Committee (TEXPAC) is a bipartisan political action committee of TMA and affiliated with the American Medical Association Political Action Committee (AMPAC) for congressional contribution purposes only. Its goal is to support and elect pro-medicine candidates at the federal level and the state level. Voluntary contributions by individuals to TEXPAC should be written on personal checks. Funds attributed to individuals or professional associations (PAs) that would exceed federal contribution limits will be placed in the TEXPAC statewide account to support nonfederal political candidates. Contributions are not limited to the suggested amounts. TEXPAC will not favor or disadvantage anyone based on the amounts or failure to make contributions. Contributions used for federal purposes are subject to the prohibitions and limitations of the Federal Election Campaign Act.
Contributions or gifts to TEXPAC or any county medical society PAC are not deductible as charitable contributions or business expenses for federal income tax purposes.
Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and name of employer of individuals whose contributions exceed $200 in a calendar year. To satisfy this regulation, please include your occupation and employer information in the space provided. Contributions from a practice business account must disclose the name of the practice and the allocation of contributions for each contributing owner. Should you have any questions, please call TEXPAC at (512) 370-1365.