To strengthen its financial base and address the continually growing needs of Texas physicians, the Texas Medical Board (TMB) is asking state lawmakers for more spending authority as part of its legislative appropriations request for the 2028-29 biennium.
Texas Medical Association President Bradford W. Holland, MD, wrote in support of TMB in a Sept. 1 letter to the interim director of the Legislative Budget Board and Gov. Greg Abbott’s budget director.
“Having a well-run, efficient, and adequately staffed and resourced TMB is essential for meeting our growing state's physician recruitment and retention needs,” the Waco otolaryngologist wrote.
As a self-funded agency, TMB reported it collected $42.8 million during the 2025 fiscal year and received $21.2 million in appropriations, or about 50% of collected fees, available to spend on the agency’s needs. The board is proposing the 3% mandatory reduction for the next budget as directed by Governor Abbott.
At the same time, it is asking for more spending authority – not a new taxing power or fee increases – to shore up its financial stability. If the Texas Legislature returns more of those collected fees to the agency, TMB reports it will be better positioned to respond to new unfunded state mandates such as continuing medical education and lawful-presence verification requirements.
“The agency’s ability to generate revenue is not the limiting factor. Rather, appropriated authority determines TMB’s ability to convert available resources into the workforce, technology, and operational capacity necessary to fulfill its statutory responsibilities,” the agency wrote.
Dr. Holland stressed that the state’s physician workforce must keep pace with Texas’ continued population boom, and with continuing historic high numbers of license applications.
Last fiscal year, TMB processed a record 8,270 medical license applications, according to agency data, edging out the previous record of 8,232 set in 2023. In 2025, TMB licensed 7,539 new physicians, just below the high-water mark of 7,609 set in 2024.
Since Texas passed landmark professional liability reform legislation 23 years ago – a signature victory for TMA’s advocacy efforts – the state has issued a total of 97,249 new medical licenses.
TMB also sees a high workload related to the Interstate Medical Licensure Compact and telemedicine.
All of this happens in conjunction with TMB’s renewals of more than 100,000 medical licenses, along with the tens of thousands for several other health professions overseen by the agency, Dr. Holland wrote. TMB is also responsible for maintaining a fair disciplinary process to protect the public.
For more information about TMA’s advocacy efforts, see the Physician Advocacy page online.