Capitol Update: HHS Commissioner to Senate Finance: Spare primary care

posted 02.10.11

Tom Suehs, executive commissioner of Texas Health and Human Services, addressed the Senate Finance Committee in a hearing on Feb. 1, and he told the 15 senators that going through with cuts to primary care proposed in the Senate’s draft budget will damage access to care.

Suehs asked the committee to approve exceptional items that would reduce the cut in payment for primary care physicians treating kids enrolled in Medicaid and CHIP from 10 percent to 2 percent. This would cost the state around $125 million in general revenue next biennium, according to a Feb. 1 article in Quorum Report.

“I’m really concerned about having to cut primary care rates for physicians treating children,” Suehs told the committee. “We’ve already cut 2 percent this biennium from when y’all wrote the [2010-2011] budget. I believe that’s about as far as I can tolerate to maintain the access to primary care so I’m asking to put back not all 10 percent, but 8 percent. Exceptional item 1A is for Medicaid children, exceptional item 1B is for CHIP.”

Suehs emphasized his desire to make “targeted cuts to minimize hits to access to care” rather than an across-the-board cut for all health care providers.

TAFP CEO/EVP Tom Banning sees Suehs’ action as a positive indicator that primary care will survive the drastic cuts proposed in the House and Senate budgets. He wrote in an e-mail to Academy leaders, “I think this clearly points to the value and importance that HHSC and the legislative leadership is placing on primary care. This should play well into our strategy to restore higher education funding to produce the primary care workforce Texas needs to achieve their policy objectives.”

“No easy choices” in higher ed funding as Senate Finance takes up Article III

The Senate Finance committee heard testimony from the Texas Higher Education Coordinating Board regarding Article III funding in the Senate version of the 2012-2013 budget this week. That’s the section of the budget containing about $51 million in programs intended to increase the state’s primary care physician workforce. Senate Bill 1 would remove approximately $14.6 million from those programs, a 28.6 percent reduction. The House budget would erase the programs completely.

Sen. Bob Deuell, R-Greenville, who is also a family physician, asked THECB Commissioner Raymund Paredes several questions in an illuminating exchange.

Deuell: “The shortage of primary care physicians in the state though is not related to a shortage of qualified pre-medical students. Is that a true statement today?

Paredes: Yes.

Deuell: “So where is the shortage coming from? Is it not coming from graduate medical education then?”

Paredes: “There’s no doubt that eliminating or cutting the residency programs that you’re referring to will have an impact on our ability to meet the needs for physicians in Texas. There’s no doubt about that.”

Sen. Deuell then listed the programs scheduled to be cut, including the Statewide Primary Care Preceptorship Program—in which Deuell participates as a preceptor—family medicine residency funding and other GME funding administered by the coordinating board, and the newly enhanced Physician Education Loan Repayment Program.

Deuell: “The cuts as is today are going to cut down on primary care physicians and health care to rural and underserved areas.”

Paredes: “Unfortunately that would be one of the consequences of this budget. As you know senator, there were no easy choices. There were only some that were less onerous than others.”

Debate on the Senate version of the budget will continue in coming days. Both the House and Senate budgets represent a starting point for weeks of committee work. TAFP will advocate for increased investment in primary care, providing testimony, data, issue briefs, policy documents, and by engaging TAFP’s Key Contacts who will reach out to their representatives and help make the case. You can join the Key Contact program by going to the Key Contacts page of www.tafp.org.

Also, you can stay informed on what’s happening under the dome by watching your e-mail inbox for each edition of QuickInfo. During the session, each edition will lead with the TAFP Capitol Update. We’ll release Capitol Report, our first webcast news show of the session, next week, so stay tuned.

Straus announces House committee appointments

Yesterday, Feb. 9, House Speaker Joe Straus, R-San Antonio, released committee assignments for the 38 standing, procedural, and select committees. As committee action makes up one significant stage of the lawmaking process, committees hold great power in deciding whether a bill becomes a law. The committees and committee chairs listed below will likely hold hearings and hear testimony on many of the bills that affect your patients and practices.

• Appropriations: Rep. Jim Pitts, R-Waxahachie
• Higher Education: Rep. Dan Branch, R-Dallas
• Human Services: Rep. Richard Peña Raymond, D-Laredo
• Insurance: Rep. John Smithee, R-Amarillo
• Public Health: Rep. Lois Kolkhorst, R-Brenham

See the full list of committee assignments on the Speaker’s website.

Thanks to the Physicians of the Day; volunteers still needed

Thanks to all of the physicians who have volunteered for the Physician of the Day program this week and last: Mary Helen Morrow, M.D., of North Zulch; Gregory Johnson, M.D., of Manvel; Paul Guttuso, M.D., of Mabank; Russell Thomas, M.D., of Eagle Lake; Clare Hawkins, M.D., of Baytown; Larry Kravitz, M.D., of Austin; Julie Graves Moy, M.D., of Austin; and Kimball W. Bockmon, M.D., of Austin.

The Physician of the Day program brings a family physician to the Capitol each day of the legislative session to provide health care to members of the Capitol community. TAFP still needs volunteers during the 82nd Legislature. View more information about the program, including the online calendar of available dates, on the Physician of the Day page of the TAFP website.