May 27, 2011

Budget Hung Up on School Finance Plan; Smoking Ban Snuffed

TMA Legislative News Hotline

Friday, May 27, 2011

With four (counting today) days left in the regular session, Texas lawmakers have a draft budget in place, but still have no way to pay for it all. The 2012-13 spending plan that budget negotiators approved yesterday will go to the full House and Senate for approval tomorrow. Still up in the air, though, is a bill that would change the state’s public school finance system to account for a $4 billion cut to public education. Several potential compromises appeared promising yesterday but fizzled out quickly. Stay tuned.

Plenty of bills found new life yesterday as they were added by amendment to the few pieces of legislation still in play for the session. Others found that their lifeboats weren’t quite big enough. Texas Medical Association’s lobby team had one in each category:

Statewide smoking ban: Because it would save the state Medicaid program more than $31 million over the next two years, a measure that would have prohibited smoking in restaurants, bars, and other public facilities was tacked onto a broad revenue-raising bill last week. Yesterday, House-Senate negotiators on that bill — Senate Bill 1811 by Sen. Robert Duncan (R-Lubbock) — said the smoking ban had been snuffed out. TMA is working with supporters such as Rep. Myra Crownover (R-Lake Dallas) to find a new last-minute way to pass this important public health measure.

Women’s health: It looks like the controversial but highly cost-effective program that provides contraception and reproductive health screenings to tens of thousands of low-income women will survive. The program was slated to end this year without legislative action, and bills by Sen. Robert Deuell, MD (R-Greenville), and Rep. Garnet Coleman (D-Houston) didn’t make it through the end-of-session logjam. But yesterday, word leaked out that the final 2012-13 state budget document now includes an amendment that would keep the Women’s Health Program at least somewhat alive for the next two years. Advocates are praising the work of Senators Deuell, Steve Ogden (R-Bryan), and Leticia Van de Putte (D-San Antonio) for this maneuver.

Health care collaborative: SB 8 by Sen. Jane Nelson (R-Flower Mound) is in conference committee. It would establish a statewide plan for improving quality and increasing efficiency through performance-based measures, test collaborative models between physicians and other health care providers, and require public reporting of preventable readmissions and complications. TMA, the Texas Association of Health Plans, and the Texas Hospital Association have negotiated how the new paradigm in the bill would play out in the real world. As a result of these negotiations, three important provisions have been added to SB 8 to protect physicians in a collaborative arrangement:
  • Physicians would have an equal say and vote in a collaborative arrangement’s governing board.
  • They also would have due process protections and the ability to participate in more than one collaborative arrangement in their community.
  • The bill also protects Texas’ ban on the corporate practice of medicine.
The TMA team is working to ensure that good amendments stay in the bill and bad amendments get stripped off.

Medicaid savings: Also in conference committee is Senator Nelson’s SB 23, another critical piece of the budget puzzle. The bill would save about $500 million, primarily in Medicaid and the Children’s Health Insurance Program. A few ways it achieves the savings are by expanding Medicaid managed care into the Rio Grande Valley, requiring Medicaid patients to use medicines on a state preferred drug list, and requiring Texans with disabilities to get home health services through Medicaid first. On this bill as well, the TMA team is working to ensure that good amendments stay in and bad amendments get stripped off.

The regular session of the legislature must adjourn by midnight Monday. It already appears as if we might have a special session on several issues — school finance, sanctuary cities, congressional redistricting. And who knows whether the budget will make it through in time? Your TMA lobby team — and TMA Legislative News Hotline staff — will work through the holiday weekend to represent you and keep you informed.

James R. Brown, MD
The physician of the day at the capitol is James R. Brown, MD, of Austin. Dr. Brown has practiced family medicine for 26 years. He graduated The University of Texas Health Science Center at Houston in 1982. Dr. Brown is a member of TMA and the Travis County Medical Society.

Remember Eight, at Eight, on the Eighth: Want to learn how the 2011 legislative session affects you and your patients? Then remember these three numbers: 8, 8, and 8. On June 8 at 8 pm, you can learn what actions legislators took on medicine’s top eight issues.

TMA President C. Bruce Malone, MD, will call you at your home telephone number and invite you to stay on the line for TMA’s Tele-2011 Legislative Update. For the next 45 minutes, Dr. Malone and members of TMA’s Council on Legislation and TMA’s lobby team will discuss these eight issues:

1.    2012-13 state budget,
2.    Employment protections,
3.    Texas Medical Board reform,
4.    Scope of practice expansions,
5.    Health system reform,
6.    Workforce,
7.    Public health, and
8.    Health insurance reform.

You may ask questions after each topic and use your phone to participate in a survey. And, the best part: You will earn 1 AMA PRA Category 1 Credit™ for your time (providing you stay on the line for the entire program).

If you prefer that we call you on your cell or office telephone, please contact the TMA Knowledge Center by telephone at (800) 880-7955 or by email by Friday, June 3, and let us know. We hope to talk to you on June 8.

TMA’s Message: Want to know where TMA stands on issues before House and Senate committees this session? All the testimonies presented by TMA leaders are on the TMA website. You can also find letters TMA has sent to our state leaders.

Read Action: Every two weeks, TMA publishes a web edition of Action. Action presents important and timely information about legal, economic, regulatory, and legislative affairs that Texas physicians need to know. Here is the May 18 edition.

Women's Health Program Stands, but Questions Remain (Texas Tribune)
Doctors tout Texas' brand of tort reform (Houston Chronicle)
Texas smoking ban snuffed out of spending bill (Houston Chronicle)

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