Texas' health care system underwent big changes in 2013 between the rollout of the Affordable Care Act and the abortion restrictions that passed in the 83rd legislative session. Lawmakers also spent months debating a proposed Medicaid expansion and the best way to reform the beleaguered Cancer Prevention and Research Institute of Texas.
Allegations of impropriety and misspent money at CPRIT surfaced shortly before lawmakers entered the 83rd legislative session. They held multiple hearings to grill former CPRIT leaders and questioned whether the institute could continue its mission of financing cancer research and prevention. Ultimately, they approved measures to strengthen conflict of interest protections and restored the institute’s 2014-15 operational budget. In December, just weeks after a 10-month moratorium on CPRIT grants was lifted, the Travis County District Attorney’s Office indicted the institute’s former commercialization officer, Jerry Cobbs, for allegedly securing an $11 million CPRIT grant unlawfully.
The medical community, local government leaders and health care advocates pushed lawmakers to expand Medicaid under the federal Affordable Care Act, or to propose an alternative “Texas Solution” to reform Medicaid. They hoped to find a way to draw down billions in federal dollars to expand health coverage for the poor. But Gov. Rick Perry and legislative Republicans refused to expand a “broken” program, and instead approved a measure to block the Health and Human Services Commission from expanding Medicaid eligibility without legislative approval.
To mitigate the damage caused by the Republican-led Legislature’s decision in 2011 to cut family planning financing by two-thirds — the closure of 76 family planning clinics and an estimated 24,000 additional births — lawmakers approved the largest financial package for women’s health in state history, including $100 million to expand a primary care program aimed at women.
Lawmakers also approved tens of millions of dollars in financing to replace the joint state-federal Medicaid Women's Health Program with a state-run Texas Women’s Health Program — the key difference between the programs being that the new one, which launched Jan. 1, excluded Planned Parenthood clinics. Although state leaders say they are committed to improving the cancer screening and contraception program, it got off to a rocky start, with declining claims for services and enrollment.
After Sen. Wendy Davis, D-Fort Worth, stalled passage of anti-abortion legislation with a filibuster heard 'round the world, Perry called lawmakers back for another special legislative session to ensure the strict abortion regulations were approved. While thousands of protesters descended on the Capitol, Republican lawmakers passed the omnibus abortion regulations. Part of the new law took effect in October, and many abortion clinics that do not meet the new requirements have been unable to perform the procedure. The U.S. Supreme Court has refused to intervene in a lawsuit challenging the law, which will proceed in the 5th Circuit Court of Appeals in January.
If you missed any of the health care policy changes in the 83rd legislative session, we created an interactive with links to the legislation that passed and to the Tribune’s coverage. Lawmakers approved bills to overhaul Medicaid’s long-term care system, target Medicaid fraud, expand scope of practice for nurse practitioners and physician assistants, and improve access to care, among other reforms.
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