Budget Starting Points: Wins on Workforce, Behavioral Health and Medicaid Add-On Payments
When THA completed its review of the Texas House and Senate’s initial budget bills last week, its policy staff had uncovered plenty for hospitals to cheer about, and/or be satisfied with.
The state’s depleted hospital workforce – a top priority for hospitals even before the COVID-19 pandemic thinned out the ranks further – gets a would-be boost in both House Bill 1 and Senate Bill 1, which spell out proposed funding for the 2024-25 biennium. Both bills mete out:
- $46.8 million for the Nursing Shortage Reduction Fund, a sizable increase from the $18.4 million allotted for 2022-23;
- More than $7 million for the Nursing Faculty Loan Repayment Program, more than double the current budget; and
- $233 million for the Graduate Medical Education (GME) Expansion Program to increase GME slots at state medical schools, a $34 million increase.
Behavioral health – another THA priority area driven by COVID-19 – received several strong proposed budget allocations as well. The Loan Repayment Program for Mental Health Professionals, currently funded at $2 million over the biennium, would receive $28 million for 2024-25 – double THA’s own budget request. And the bills allocate $126 million each year to for state psychiatric bed capacity, enabling the state to add 234 inpatient beds (85 for rural communities and 149 in urban areas).
Adequate Medicaid funding is always a top priority for hospitals, but Medicaid often appears vulnerable to the budget-slashing desires of some lawmakers. So it was good news for hospitals to see HB 1/SB 1 give overall Medicaid spending a slight increase and hold the line on funding for several important add-on payments: safety-net ($150 million annually), trauma ($180 million), rural outpatient ($30 million) and rural labor and delivery services ($8 million).
You can view THA’s full summary of the initial budget bills here.
Senate Committee Assignments: Kolkhorst Chairing HHS
Sen. Lois Kolkhorst (R-Brenham) is once again chair of the Senate Committee on Health and Human Services (HHS) after Lt. Gov. Dan Patrick reappointed her to that important post last week. Sen. Charles Perry (R-Lubbock) will be the committee’s vice chair. Other HHS members for this session include:
- Sen. César Blanco (D-El Paso);
- Sen. Bob Hall (R-Edgewood);
- Sen. Kelly Hancock (R-North Richland Hills);
- Sen. Bryan Hughes (R-Mineola);
- Sen. Morgan LaMantia (D-South Padre Island);
- Sen. Borris Miles (D-Houston); and
- Sen. Kevin Sparks (R-Midland).
The lieutenant governor’s committee assignments for this session included no physicians on the health and human services committee, following a 2021 session in which two doctors served on the committee. However, Sen. Charles Schwertner, MD (R-Georgetown) was appointed chair of the Committee on Business and Commerce, another committee hospitals and THA will keep an eye on because it has historically handled health insurance regulation.
Sen. Brandon Creighton (R-Conroe) was picked as chair for the Committee on Education and the Subcommittee on Higher Education, the latter of which will help determine the Legislature’s course on hospital workforce issues, such as physician and nurse training.
As of Friday, the House had not announced its committee assignments.