Medicine Urges Funding for Medicaid, Safety Net Programs as ‘Backbone’ of Texas Health Care
By Phil West

In support of what they dub “the backbone of Texas’ health care delivery system,” the Texas Medical Association and Texas Pediatric Society (TPS) urge budgetary support for Medicaid, the Children’s Health Insurance Program (CHIP), women’s health programs, and behavioral health services ahead of the 2027 legislative session.

The state's Legislative Budget Board held a Sept. 24 hearing on the Texas Health and Human Services Commission (HHSC) 2028-29 budget. There, TMA supported full funding of the commission’s base budget and several additional items HHSC identified. That includes a call to make sure appropriations keep up to meet the need for Medicaid and CHIP.

“Millions of Texans benefit directly from these programs, but all Texans gain when our collective neighbors can obtain timely access to preventive, primary, and specialty care services,” TMA and TPS said in their jointly filed written testimony. They added that physicians “rely on having robust, effective, and efficient safety-net programs” to effectively provide health care to all their patients.

“To ensure frontline preventive health, maternal care, and early intervention programs remain intact,” the groups also urged HHSC to submit an additional budget request to restore funding lost to the 3% budget reduction called for via a July directive to state agencies from Gov. Greg Abbott, Lt. Gov. Dan Patrick, and Texas Speaker of the House Dustin Burrows.

TMA and TPS said vital programs at risk include the Nutrition Incentives program, rural mental health services, underserved pediatric telemedicine infrastructure, and community mental health grants.

They also posited the Healthy Texas Women program could see funding reductions for its care-management services, which help women with enrollment, and provide payment support which offsets costs for clinics providing women with essential services.

Specifically for Medicaid, the testimony encouraged funding to:

• Process application backlog. Between January and August 2026, Medicaid’s application backlog surged from 2,000 to more than 183,000, while the Supplemental Nutrition Assistance Program (SNAP) backlog grew from 4,000 to more than 126,000;
• Maintain Medicaid waiver programs and reduce barriers within Medicaid waiver interest lists, which support home- and community-based services for children and adults with complex needs, allowing them to avoid costlier institutional settings; and
• Expand Medicaid benefits for mental health programs that address gaps in care for children with high-acuity behavioral health needs.

Additionally, TMA and TPS seek to bolster HHSC’s efforts to modernize its aging technology, as well as the Office of Inspector General’s capacity to review and process provider enrollment screenings. Per the office's website, state law requires those evaluations be completed within 10 days; they currently take 90 to 120 days.

TMA and TPS also highlighted their support for:

• Sustaining SNAP. In 2027, the federal government will reduce its share of covered costs for the program, which 3.5 million Texans, including 1.8 million children, rely on; and

• Supporting the Early Childhood Intervention program, which has weathered a 22% drop in community caregivers over the past decade due to funding factors TMA calls the program “a lifeline for Texas families navigating the needs of infants and toddlers with developmental delays and disabilities.”

Review TMA’s testimonies, which advocate for physicians’ top priorities heading into the upcoming legislative session.