By Jonathan Nelson
In yet another week of important committee meetings at the State Capitol, two family physicians provided testimony on some of TAFP’s top legislative priorities for the 86th Texas Legislature. On Monday, February 11, the House Appropriations Subcommittee on Article II convened to hear testimony from agencies and the public. Article II of the state budget contains funding for all agencies and programs that fall under Texas Health and Human Services, including Medicaid, CHIP, Healthy Texas Women, the Family Planning Program, services for the aging and those with disabilities, and much more.
TMA President and former TAFP President Doug Curran, MD, of Athens, told the committee that while Texas is indeed booming with a strong economy and lots of opportunity, many of the state’s health care statistics rank well below the national average.
“When 20 percent of our people between 19 and 64 have no health care coverage, that’s a real problem. Most of those people have a job … and they still can’t make it work,” he said. “When my son’s health insurance costs more than his house payment, we’ve got a problem. … And our kids, when you look around and 20 percent of the kids who are uninsured in this country live in Texas, that’s a problem.”
He also told the committee that physician payment rates in Medicaid and CHIP lag far below Medicare rates, and that hurts the programs and restricts access to care for some of the most vulnerable patients.
Curran laid out a range of funding proposals TAFP, TMA, and other specialty societies are advocating this session.
- Improve child health and well-being by funding the Children’s Coverage Bill, House Bill 342 by Rep. Phillip Cortez and HB 829 by Rep. Toni Rose, which will establish 12 months’ continuous coverage for children in Medicaid.
- Promote better birth outcomes by funding legislation to provide comprehensive health care coverage to low-income women before and after pregnancy, including HB 1110 by Rep. Sarah Davis.
- Revitalize the Medicaid and CHIP physician network by allocating $500 million general revenue over the biennium toward Medicaid physician payment increases.
The following day, TAFP Past President Tricia Elliott, MD, of Fort Worth, testified before the Senate Finance Committee. She asked the committee to restore funding to the Family Practice Residency Program, a funding strategy of the Texas Higher Education Coordinating Board that directly supports many of the state’s family medicine residencies.
“Our state’s 33 family medicine residency programs are the lifeblood of our primary care physician workforce, preparing more than 300 new family physicians for practice each year,” she said. “These programs and their residents provide well-coordinated, cost-effective care to communities that need it. A significant portion of the care they provide is for Medicaid and CHIP patients, Medicare patients, and the uninsured.”
Last session, the Legislature cut funding for this strategy by 40 percent, increasing the fiscal strain family medicine residency programs suffer. Elliott asked committee members to allocate $20 million for the coming biennium to the strategy, bringing its funding level to its historic average from 2002 to 2010.
“We’ve done a great job of building new GME positions, but we must continue to support our existing programs so they can continue to produce the family physician Texas so desperately needs.”
She also asked the committee to increase access to care for Texans by restoring funding to the Physician Education Loan Repayment Program. Through this program, physicians can receive loan assistance up to $160,000 in return for four years of practice in a federally designated Health Professional Shortage Area.
“The program brings doctors to underserved communities and has made a huge and lasting difference for Texans who lack access to needed care. The 771 physicians who have enrolled in the Physician Education Loan Repayment Program since 2010 are a testament to its effectiveness,” she said. “The bottom line is this program works and has placed physicians in rural communities, urban centers, community health centers, and correctional facilities — all places where Texans suffer a lack of access to care.”
Thanks to these members who traveled to Austin to fight for patients and for family medicine. For information on how you can get involved in TAFP’s advocacy efforts this session, visit https://www.tafp.org/advocacy/get-involved.