After many hours of debate, the Texas House passed a bill that would strengthen CHIP, the state’s children’s health insurance program, on April 3. The day began with a rally on the Capitol steps as medical students and physicians from across the state joined the bill’s sponsor, Speaker Pro Tempore Sylvester Turner, D-Houston, in support of House Bill 109.

“We have labeled this session as a session involving insuring and protecting our kids,” Turner said to the crowd of physicians, reporters and spectators. “At the end of 140 days, we will be evaluated in terms of how well we have insured them, and by how well we have protected them, and today, we take a major step forward in insuring our kids.”

The bill reinstates the original 12-month enrollment period, it relaxes the asset test, it removes the 90-day wait for new enrollees and it allows families to deduct their childcare expenses from their reported annual income. These changes are intended to remove barriers enacted in 2003 that make it difficult for families to enroll their children in the program. Rep. Turner expects that the bill would add 170,000 kids to the program.

The bill now moves to the Senate where it will face an uphill battle. Sen. Leticia Van de Putte, D- San Antonio, joined several legislators at the press conference, telling the crowd that she looks forward to the day they get the bill signed in the governor’s office.

“The untold story here is that Texas taxpayers have left $893 million of your hard-earned money in Texas up at the federal level because we didn’t draw that down,” she said. “And so other states and other children in this country have gotten the benefit. And not that we don’t love the little children in New York and California, Florida, Georgia, those states that tell us thank you for getting our CHIP allocations, but we just want to take care of our kids at home. We want to get back to the original design. We can no longer afford to lead this country with the highest number of uninsured children.

Medicaid reform bill voted out of committee

The Senate Health and Human Services Committee passed an omnibus Medicaid reform package on Tuesday, April 3. Senate Bill 10 by Sen. Jane Nelson, R-Flower Mound, would implement an ambitious set of changes in the program, including expanded premium assistance, health savings accounts and tailored benefit packages to fit specific patient types. It would also establish a three-share program, whereby employers and employees each pay a portion of health insurance premiums and the state pitches in for the rest.

Gary Floyd, M.D., a pediatrician from Keller, testified before the committee on behalf of the Primary Care Coalition, a group comprised of TAFP, the Texas Pediatric Society and the Texas Academy of Internal Medicine Services. He told the committee members that preventive health care has to be the cornerstone of promoting any health care system.

“We feel physicians are a key in any type of reform, to promote prevention, to promote health care, long term care, and we appreciate all of your efforts in focusing on the reimbursement level to physicians who provide for Medicaid and CHIP patients,” he said. “Without that, we cannot effectively build or enlarge the pool of physicians who take care of that population.”

Federal hearing draws near in Frew v. Hawkins

As we reported, the House passed the state budget late last week, but a 14-year-old federal lawsuit could throw a wrench into Senate budget deliberations. The class action suit, called Frew v. Hawkins, claims that Texas children in the Medicaid program do not have sufficient access to physician services or preventive care. U.S. District Judge William Justice will hear the case on Monday, April 9, but how soon he will issue a ruling is anyone’s guess. Estimates for what it will cost the state to comply with the order range from $500 million to $5 billion.

Some predict that if the ruling comes down after the session has ended, lawmakers could be recalled for an emergency special session. In hopes of avoiding that fate, the Senate Finance Committee passed a contingency measure that would direct the Legislative Budget Board and the Health and Human Services Commission to pay for the ruling by drawing money first from the current Medicaid appropriation and then from any other area of general revenue.

Debate over the budget rider, by Sen. Robert Duncan, R-Lubbock, has been heated. Sen. Judith Zaffirini, D-Laredo, voiced her opposition to the rider.

“My concern is that at a time when we have money and can afford to pay for Frew, and many other services. We are taking from one needy area to fund another needy area,” she said, adding that the committee’s action could be viewed as mean-spirited by the judge. “I’m totally confident that the people who filed this lawsuit expected us to spend more money in Health and Human Services and not less.”

The rider will be a part of the budget the committee eventually sends to the full Senate, but it still could be stripped off in conference committee after being passed by the Senate.

House passes expedited credentialing bill

House Bill 1594 by Rep. John Zerwas, M.D., R-Richmond, was voted out of the House and will now head to the Senate for approval. HB 1594 would expedite a physician’s credentialing process under certain health insurance plans. This allows physicians to begin building their patient base immediately after joining a new practice and ensures patients seeing these physicians receive in-network rates even as their physician is waiting for credentials.

Thanks to these Physicians of the Day

TAFP would like to thank this week’s physicians who volunteered to serve at the Texas Capitol as Physician of the Day. Participating physicians were Syed Azhar, M.D., of Houston; David Palafox, M.D., of El Paso; Dana Sprute, M.D., of Austin; and Linda Carney, M.D., of Buda.

We still need TAFP members to sign up to serve as the Physician of the Day during the 80th Legislative Session. Open dates in April, April 23, 25 and 26, need to be filled as soon as possible. Many more spots are also available in May. Contact TAFP’s Kate McCann by e-mail or phone at (512) 329-8666 for more information, or visit our Physician of the Day page of the TAFP Web site.