• Red-tape reductions, including the elimination of the Department of Public Safety (DPS) controlled substances registration (CSR) permit;
• First-ever regulation of e-cigarettes; and • A tax break for all licensed physicians.
Key to medicine’s success, TMA leaders say, were the relationships physi-
“We did a heck of a lot of good this session, and there’s no question the grassroots [physician effort] is what helped us.”
cians built in their hometowns with new and familiar faces in the legislature, bolstered by hundreds of doctors, medical students, andTMAAlliance members who lobbied and testified at the Capitol throughout the session. TMA Council on Legislation Chair Ray Callas,MD, says those grassroots ef-
forts started when TEXPAC, the association’s political arm,went to bat early in one of the most significant election seasons in decades, marked by the departure ofGov. Rick Perry and big turnover at the Capitol and in statewide offices. TEX- PACemerged strong, winning and preserving key seats held by physicians,TMA Alliance members, and other pro-medicine candidates. Thanks to that groundwork, the many new faces in the legislature and in state leadership were knowledgeable of medicine’s issues and kept an open door, says Dr. Callas, a Beaumont anesthesiologist. And even though not all ofTMA’s bills made it to the finish line, medicine did not lose ground. With tax cuts threatening TMA’s budget priorities, more than 70 dangerous
scope-of-practice bills filed, and end-of-life debates resurfacing, “we knew we had some obstacles to face,” Dr. Callas said. “But our mind-set going in was we felt very strongly we were committed to doing whatever we had to do to protect the practice of medicine for our patients. Our biggest win was making sure the practice of medicine is still sacred.” An effort to add a pathway for expedited physician licensing did not survive,
but TMA kept a slew of scope-of-practice expansions from seeing daylight and successfully warded off attempts to erode state telemedicine rules requiring a physician-patient
relationship.TMAnegotiated an end-of-life compromise bill, while preserving physicians’ ability to protect their patients and exercise their professional ethics. A statewide texting ban failed another session but so did a balance-billing ban, thanks also to aTMA-negotiated compromise. The biggest disappointments: Despite theHouse’s advancement of a measure
to continue paying select primary care physicians at rates that matchMedicare per the Affordable Care Act, the plan dissipated in the finalweeks of the session in favor of shifting the funds into sweeping tax cuts. ACA increasedMedicaid primary care payments toMedicare rates for two years using federal funds, but the pay bump expired Dec. 31, 2014. And while more moneywent to mental health services, Governor Abbott ve-
toed a measure allowing emergency physicians to protect patients with mental illness who pose a danger to self or others. TMAPresident TomGarcia,MD, called the two decisions “troublesome. But
we will continue to fight.” Goals likeMedicaid paritymay take longer than ex- pected to achieve, but he says that does not mean they are out of reach. Still, overall, Dr. Garcia says, “We did a heck of a lot of good this session, and
there’s no question the grassroots [physician effort] is what helped us. If we did all this with just 10 percent of TMA members in TEXPAC, imagine what we could do with 100 percent.”
GME BOOST, TAX CUTS FOR ALL Tax cuts were a major priority for Governor Abbott andHouse and Senate lead- ers and largely drove budget
negotiations.Meanwhile, the sunset review pro- cess—which the legislature uses to regularly evaluate the performance of state agencies, this time, health agencies — steered a number of health care policy
August 2015 TEXAS MEDICINE 29
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