AUSTIN, TX (ASRN.ORG)- The Texas Legislature made significant improvements to Texas health care that will benefit consumers as well as health care providers. Small businesses and low-income individuals in the Texas High Risk Pool will find health insurance coverage more affordable, and college students will find health coverage more accessible. Texas nursing schools will be able to enroll more students for the fall semester, which will produce more graduates to ease the state's nursing shortage. Several measures passed that will increase the supply of physicians in rural and other underserved areas. And, lawmakers used federal stimulus funds to fill the shortage in Medicaid for 2009 and increase funding for Medicaid caseload and cost growth projections for 2010-11.

"This was a productive session for hospitals," said Dan Stultz, M.D. "For the past three sessions, the Texas Hospital Association has been working to reduce the number of uninsured Texans. Again this session, lawmakers made incremental reforms that address segments of the uninsured population," he noted. "And, lawmakers made the largest investment ever in nursing education -- a total of $49.7 million. This investment will translate to jobs for decades to come," he added. "Those residing in rural and medically underserved areas along the border and in large cities should have better access to doctors, thanks to a loan repayment program and new authority for certain public hospitals to employ physicians," Stultz said.

Addressing the Uninsured

"Sen. Jane Nelson passed legislation creating the TexLink to Health Coverage Program at the Texas Department of Insurance to help consumers and small business understand available health coverage options, as well as to promote awareness of and the importance of purchasing health insurance," Stultz said.

Sen. Nelson's bill became a vehicle for another bill to help small employers. "Sen. Robert Duncan's legislation creates the Healthy Texas Program, which provides a reinsurance mechanism for qualifying small employers. Based on the experience of other states, this program is estimated to reduce insurance premiums by about 30 percent for participating employers," Stultz explained. The budget includes $35 million for the biennium to implement the program.

"Sen. Dan Patrick and Rep. Fred Brown passed legislation that will ensure that large universities offer health care coverage to students and accept private insurance for care they provide."

Nursing Education

"In 2008, Texas nursing schools turned away some 8,000 qualified applicants due primarily to a lack of faculty. The Legislature made $30 million in new upfront funding available so nursing schools can increase their enrollment this fall, and all schools producing graduates to become registered nurses are eligible to participate," Stultz said. The new funds are in addition to $14.7 million in the base budget to increase nursing school funds following enrollment growth, plus $5 million for a new simulation lab at The University of Texas at Arlington.

Physician Issues

"Sen. Duncan, Rep. Garnet Coleman and a number of legislators representing rural hospitals led efforts to allow rural hospitals to employ physicians, which will make it easier to recruit doctors to remote areas of the state," Stultz said. The measure was added to a county services bill by Rep. Coleman; the final bill allows the Dallas County Hospital District and hospitals in counties with a population of 50,000 or less and operated by a governmental entity, such as a county hospital or hospital district, to employ physicians. "The bill contains important protections to preserve the independent medical decision-making of employed physicians, and to ensure that physicians are treated equally in medical staff bylaws and policies, regardless of their employment status," Stultz added.

Rep. Warren Chisum introduced a change to the tax on smokeless tobacco products to fund a physician loan repayment program for those who practice in underserved areas for at least four years. "This legislation will provide some 225 new physicians annually to underserved areas of the state. Of the 114 Texas counties considered Health Professional Shortage Areas, more than 75 percent are in rural areas," Stultz explained.

Health Care Funding

Legislators used federal stimulus dollars to fill the 2009 shortfall in Medicaid, fund increases in Medicaid caseload and cost projections for 2010-11, and support community mental health crisis services to keep patients in crisis out of hospitals and criminal justice system. A total of $109.4 million was appropriated for these mental health facilities.

Lawmakers appropriated $75 million per year from the Designated Trauma and Emergency Medical Services Account to help offset uncompensated trauma care costs at designated trauma hospitals. "This is a significant increase from the $52 million per year appropriated for 2008-09, but all of the dollars accumulating in this account should be used as they were intended. Hospitals reported about $196 million in uncompensated trauma care last year," Stultz said. Several bills were introduced that would have repealed the Driver Responsibility Program, the funding source for the uncompensated trauma care fund. In the end, legislators directed the Texas Department of Public Safety to create an indigency program, waiving fines and surcharges for drivers up to 125 percent of poverty; however, the program does not take effect until Sept. 1, 2011.

Copyright 2009- American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved