Capitol Update: House budget passes committee, retains stark cuts
Members of the House Appropriations Committee approved the 2012-2013 House budget bill on March 23, and expect the bill to reach the House floor for debate as early as next Friday, April 1. The House’s budget appropriates $164.5 billion in all funds, a reduction of $23 billion from the current 2010-2011 budget. It appropriates $77.6 billion in general revenue—$4.48 billion less than in 2010-2011.
Budget writers made very few changes to the bare-boned base budget released at the beginning of the session, holding true to the no-new-taxes, deep-cut approach advocated by leaders, and preserving the remaining $6.2 billion in the Rainy Day Fund.
The original version of the House budget spared no sectors from cuts, particularly health care and education. Of the issues important to the specialty, it cut Medicaid provider rates and funding for graduate medical education, and eliminated many of the programs TAFP has advocated for years to increase Texans’ access to primary care: the Family Medicine Residency Program funding from the Texas Higher Education Coordinating Board, the Statewide Family Medicine Preceptorship Program, and the Physician Education Loan Repayment Program.
House Bill 1 as approved by the committee underfunds the Medicaid program by $6 billion by not accounting for caseload and cost growth, and accounting for a less favorable federal match rate after the expiration of the enhanced federal match.
The House budget bill also retains the 10 percent cut in Medicaid and CHIP payment rates to physicians. The House Appropriations Subcommittee on Article II agreed to prioritize the restoration of most of the proposed cuts to Medicaid payments for primary care services should funds become available during later stages of the budgeting process. Under the proposal, which originated from Health and Human Services Commissioner Tom Suehs, payment for primary care services for children in Medicaid and for CHIP would be cut by only 2-3 percent rather than 10 percent.
As indicated, this doesn’t mean that cuts to Medicaid rates, GME, and other programs designed to bolster the primary care workforce will make it into the final 2012-2013 budget. The House must reconcile its bill with its Senate counterpart in conference committee, and chief budget writer Sen. Steve Ogden, R-Bryan, has indicated that the Senate’s budget cannot be as lean.
Though revenue bills must originate in the House, the Senate is taking steps to identify $5 billion in non-tax revenue for its budget—which include actions such as selling state property, closing tax loopholes, and increasing state fees—through the newly-formed Senate Finance Subcommittee on Fiscal Matters, chaired by Sen. Robert Duncan, R-Lubbock. The subcommittee met for the first time yesterday, March 23.
However, Appropriations Chair Rep. Jim Pitts, R-Waxahachie, said that “his colleagues in the Senate will have to lower their expectations if they want to pass a budget this session and avoid a summer special session,” according to the Quorum Report. Further, he said that many House freshmen feel that they were elected to make cuts and that the budget emerging from the House reflects what their constituents want.
“The Senate’s going to have to come way down,” Pitts said in the Quorum Report article about what might spur a special session on the budget. “And that’s the message that I give to every Senator that’ll listen and the Lieutenant Governor.”
Thanks to the physicians who volunteered for the Physician of the Day program this week: Luis Calo, M.D., of Harlingen; Ron McMurry, M.D., of Jasper; Keith Miller, M.D., of Center; and Tamara Dominguez, M.D., of San Antonio.
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. Dates are still available in April and May, including Fridays. For more information on how to sign up and to view the calendar of open dates, go to the Physician of the Day page of the TAFP website, www.tafp.org/advocacy/get-involved/physician-of-the-day.