Health Care Debate is Front and Center in SD-10

For a race that encapsulates Texas’ raging health care debates, look no further than Senate District 10 in Fort Worth — the matchup between incumbent Democrat Wendy Davis and her challenger, Republican state Rep. Mark Shelton.

Shelton, a pediatric infectious disease specialist at Cook Children’s Hospital, wants to repeal federal health reform (“this is about government-run health care versus patient-centered health care”), prevent a Medicaid expansion (“it affects access to care”) and keep Planned Parenthood far away from state-subsidized women’s health care.

“Everyone is for women’s health,” Shelton said. Planned Parenthood “is about taxpayer funding of abortions and late-term abortions. Wendy is for taxpayer-funded abortions, and I am not.”

Davis wants to restore legislative funding that has been cut from women’s health (“women of Texas have lost access to health care”), give more low-income patients access to Medicaid (“the community wants us to leave politics at the door”) and protect Planned Parenthood as a major provider of cancer screenings and preventive care in Texas.

“They’re being held hostage for political purposes,” she said of Planned Parenthood, calling Shelton an “ideologue.” “We know and he knows that those funds are prohibited from use for abortions.”

The two are engaged in a fierce battle for the swing seat, one of the most-watched and most fought-over on the November general election ballot. If Shelton wins, he gets Texas Republicans within one vote of the two-thirds majority they need to render Democrats virtually obsolete in the upper chamber. Democrats, who see Davis as a rising star in the party, want to hold fast to that 12th Senate seat; they’ve got a better chance since the courts tossed out a Republican-drawn redistricting map that would’ve changed the district’s boundaries.

The candidates have a lot to fight over; health care is just one area where their messages diverge. But their race has drawn a lot of attention from the state’s medical and social services groups, who see the matchup as a referendum on many of Texas’ biggest health care issues and have weighed in with competing endorsements.

The Texas Academy of Family Physicians, which generally works hard to add doctors to the ranks of the Legislature, endorsed Davis over Shelton. Tom Banning, the group’s executive director, said his organization followed the “friendly incumbent” rule — endorsing an incumbent whose votes closely aligned with his organization.

“Wendy’s record on the issues we care about, that our patients care about, is unassailable,” Banning said. “When it came to managed care reform, graduate medical education, scope of practice, even tort reform, she had a perfect voting record.”

Banning said that if Shelton were running for re-election in the House, the group would have endorsed him — but that to go against Davis would have sent a bad message to incumbents whom family doctors have asked to make hard votes in the past.

The Texas Medical Association, meanwhile, endorsed Shelton for the Senate seat. Though the group’s political action committee usually endorses friendly incumbents, chairman of the board Joe Todd said the doctors in the Fort Worth district have deep roots with Shelton. 

“A lot of doctors worked their tails off to get Mark elected [to the House], and they established a bond,” Todd said. “Under ordinary conditions, we would absolutely endorse [Davis]. But by virtue of Mark being a physician … it was much more of a tough call for us.”

When it comes to health care, the two candidates have finely tuned talking points — and sharp elbows. 

Shelton says Medicaid is dysfunctional, and that the massive expansion of it called for by federal health reform won’t improve patients’ access to care. He said he’s been a staunch advocate for Legislature-backed programs to improve the health of infants and provide health insurance for kids in child custody battles. And he has fought diligently against what he sees as Planned Parenthood’s efforts to get taxpayers to foot the bill for abortion.

While he backs tort reform efforts that he says have lured more doctors to Texas, he argues that his left-leaning opponent does not.

“I’m a pediatrician and I see patients, heavily Medicaid patients, every day,” Shelton said. “Wendy is an attorney aligned with the trial lawyers.”

Davis describes herself as a champion for women’s health — she relied on Planned Parenthood for contraceptives and well-woman care as a young, single parent and received an award this year from the Texas Association of OBGYNs — and blasted lawmakers, including Shelton, who voted for sweeping cuts to family planning last legislative session.

“We know that not only is it foolish in terms of the integrity of the health care system in the state, but it’s very poor fiscal decision-making,” she said.

In recent weeks, she has demanded that Gov. Rick Perry fire the state’s insurance commissioner over a dismantling of new rules designed to protect consumers from being overbilled for health coverage.

Davis called the TMA’s endorsement of her challenger “a symptom more of Mark Shelton and his cozy lobby relationships,” and said his suggestion that she would dismantle tort reform is preposterous.

“I’ve been in the Legislature for four years, and I’ve never had a conversation with anybody about unwinding tort reform,” Davis said.

They’re hot talking points on the campaign trail — and were big focuses of the Democratic and Republican national conventions of the last two weeks — but whether health care issues will sway Fort Worth voters is yet to be seen.

“It’s going to be very interesting to see how the public engages on these issues, whether it will swing votes,” Banning said.