Capitol Update: House releases stark budget draft

posted 01.19.11

House Appropriations Committee Chairman Jim Pitts, R-Waxahachie, laid out the first draft of the state budget Wednesday as he took questions from lawmakers on the House floor. Under the proposal, the state would spend $156.5 billion in 2012-2013, $31.1 billion less than in the current biennium.

While Pitts stressed that the draft only represents a starting point, he told lawmakers that it meets the requirements state leaders have called for by spending available revenue without raising taxes or using the state’s $9.4 billion Rainy Day Fund. In drafting the budget, the Legislative Budget Board assumed there would be zero population growth and zero caseload growth in Medicaid.

The bill contains massive cuts to health care and education, including a 10 percent reduction in Medicaid provider rates. That comes on top of a 1 percent cut already enacted in the current biennium.

Programs TAFP has advocated for years to increase Texans’ access to primary care were eliminated in the proposal, including the Family Medicine Residency Program funding from the Texas Higher Education Coordinating Board; the Statewide Family Medicine Preceptorship Program; and last session’s crowning achievement, the Physician Education Loan Repayment Program.

Graduate medical education formula funding, which goes to the medical schools, was $75.5 million in the current biennium. Under the draft for 2012-2013, formula funding drops to $53.9 million. Total state GME funding would drop from $118.4 million in 2010-2011 to $66.3 million.

Along with the draft budget, the Legislative Budget Board released a set of policy recommendations to improve the efficiency and effectiveness of state government. Among those recommendations was a call to grant advanced practice nurses the authority to diagnose and prescribe without physician supervision, a change the LBB advised would lower the cost of care.

“The spending proposals in the base budget don’t reflect the policy goals that the state is working toward,” said TAFP CEO Tom Banning. “There is overwhelming evidence that high-quality, cost-effective health care systems are built on a strong primary care foundation, and now is the time when we should be investing in our primary care physician workforce.”

The Senate will release its own draft budget in coming days, as will Gov. Perry. Once committee assignments are made, lawmakers will begin the arduous task of refining the budget.