BUDGET UPDATE
It’s budget day in the Texas House of Representatives, as today members are poring over House Bill 1, the House Appropriations Committee’s 2016-17 state budget proposal. That scrutiny includes vetting the more than 350 amendments.

The House budget is $209.8 billion, which includes $460 million in general revenue funds to increase Medicaid payments to Medicare levels for many primary care physicians (PCPs) and providers. The House budget is $2 billion under the spending cap.

In highlighting the Article II budget, Rep. Four Price (R- Amarillo), Appropriations Subcommittee on Article II chair, said the budget fully funds caseload growth for Medicaid and the Children’s Health Insurance Program. He said the bill:

• Funds Medicaid at an increase of $2.9 billion in general revenue, primarily due to projected caseload increases and lower federal matches; 
• Invests an additional $148.7 million to improve mental health services across Texas for adults and children; and
• Establishes $15 million in funding to expand the state’s autism program to new service regions, allowing more children access to treatment.

Medical education:Additionally, HB 1 in its pre-amendment state contained:

• A proposal to increase state medical education formula funding by 3 percent;
• A recommended $28 million for graduate medical education (GME) expansion (double the current total funding); however, the funding is for only two of the current GME expansion programs; most would receive no continued funding;
• $12 million for the family medicine residency program (which represents level funding; no increase from current funding); and
• $10 million in additional GME formula funding to go to the medical schools toward residency teaching costs, an increase of 16 percent.

Women’s health: The House maintained stable funding for the Department of State Health Services family planning program and the Texas Women’s Health Program (TWHP). TWHP provides low-income, uninsured adult women access to annual well-woman exams, contraception, preventive health screenings, and treatment for sexually transmitted diseases. With the current funding, the Health and Human Services Commission estimates TWHP will be able to serve nearly 116,000 eligible women per year. 

The House added $20 million to the Expanded Primary Health Care (EPHC) program to increase preventive and primary care services to eligible women. Like TWHP, EPHC provides low-income women access to family planning services and preventive health screenings, but it also covers primary care services, including prenatal care. The additional funding is intended not only to increase the number of women served but also to bring EPHC services to communities with gaps in coverage. The state estimates the funding will result in roughly 204,000 women being served by EPHC each year.

It is estimated 1.3 million low-income Texas women are in need of well-woman preventive care.

Maintenance of Medicaid payment increase for primary care physicians: HB 1 provides $460 million in general revenue ($1.1 billion all funds) to continue the Medicare parity payments provided to eligible primary care physicians over the past two years. As a result of the Affordable Care Act, the federal government provided states two years of funding to increase Medicaid payments to Medicare parity for select primary care services provided by PCPs. The additional funding expired on Dec. 31, 2014, so the legislature must act to fund the higher payments going forward. The House budget will fund the higher PCP payments in the 2016-17 biennium, which begins Sept. 1, 2015.

UNDER THE ROTUNDA
Today the Texas Senate passed Senate Bill 538 by Sen. Charles Schwertner, MD (R- Georgetown), which would increase the state’s preparedness for responding to infectious disease threats. The measure — inspired by several recommendations of the governor-appointed Task Force on Infectious Disease Preparedness and Response that convened after the Ebola event in Dallas — aims to improve Texas’ emergency response for infectious disease outbreaks. Members of TMA’s Committee on Infectious Diseases, including several local health authority representatives, previously recommended changes to the original bill, which TMA shared while speaking in support of the bill during Senate Health and Human Services Committee testimony.

PHYSICIAN OF THE DAY
The physician of the day at the Capitol is Darshan Shah, MD, of Austin. Dr. Shah graduated from Tufts University School of Medicine. He is a member of TMA and the Travis County Medical Society.

WHAT WE ARE READING
Supreme Court sides with Idaho in Medicaid pay dispute ― Associated Press
Supreme Court won’t hear case on Obamacare Medicare board ― Politico
House Provision Offers Doctors More Protection Against Malpractice Suits ― The New York Times
Texas health commissioner still on job after scathing report ― Associated Press 
‘It’ll be a bloody day on the House floor’ in Texas budget debate ― The Dallas Morning News