By Jonathan Nelson
The House Select Committee on Health Care Reform wrapped up two days of hearings last week in pursuit of their interim charge to provide policy solutions before the January start of the next Texas Legislature. Committee chair Rep. Sam Harless, R-Spring, kicked off more than 15 hours of invited testimony by outlining the committee’s charge.
“We are directed to look at the rising cost of health care and health care plans as well as transparency of health care plans, confusing and unequal pricing and more,” Harless said. “Our goal is to increase access and improve affordability for medical care for all Texans including the uninsured and the underinsured.”
TAFP CEO Tom Banning said the committee’s work will likely set the tone for the health policy issues the Legislature will tackle next session. “Based on last week’s hearings, I expect a focus on greater transparency on costs and quality, prohibiting anticompetitive practices of hospitals, health plans and pharmacy benefit managers, and reducing administrative costs.”
John Carlo, MD, a preventive medicine specialist provided testimony on behalf of the Texas Medical Association and a group of specialty societies including TAFP. He told the committee that according to a report by the Commonwealth Fund, in 2022 Texas ranked last on measures relating to access and affordability, “a black eye on a state with world-renowned physician practices, medical centers, medical schools, and health policy institutes.”
Carlo told the committee Texas ranks fifth in the nation for the highest rate of adults with unpaid medical bills. Prior to the pandemic, more than one in three adults across the country reported they could not afford to pay their health plan deductible before obtaining health care services.
“Every day, as a practicing physician, I see the tradeoffs patients make when confronted with health care services they cannot afford, such as skipping medications or health care services,” Carlo said. “Sadly, I and my colleagues have seen firsthand the tragic, even deadly, consequence of delayed or foregone care.”
Earlier this year, TAFP sent a letter to members of the committee expressing support for their work in trying to address rising health care costs. “Health care industry consolidation, high and rising health care prices, flawed workforce policies, inadequate access to data and a lack of transparency, distortions created by provider payment systems, including Medicaid and Medicare, the rate of uninsured, and socioeconomic factors are all inescapably linked to the increasing cost of health care.”
The letter went on to say that the committee has an opportunity to explore initiatives from the private sector and other states designed to control costs and improve quality. “While politically vexing, there is substantial evidence supported by solid economic theory that strategic investment in primary care infrastructure can demonstrably bend the health care cost curve. The value of primary care is rooted in continuous, long-term relationships — with patients and with the community — that facilitates access, assures continuity, and coordinates care of the whole person.”
The 88th Texas Legislature will convene on January 10, 2023, and is scheduled to end on May 29.