The 2013 regular session and the THREE special sessions to follow are finally over. We saw some very important wins for women’s health care and some big blows to the integrity of the doctor-patient relationship. Below you’ll find summaries of legislation and proposed rules that significantly interfere with your doctor-patient relationship.
- HB 2 by Rep. Laubenberg was the bill that passed in the second special session that, among a number of things, legislates the clinical practice of medicine by dictating a specific medical protocol. The practice of medicine by this legislation extends to specify which medications, the amounts and timing of the medications, the timing of the follow-up visit and the questions/assessments that must be performed at the visit. One of the reasons that TX-ACOG believes that the practice of medicine should not be legislated is exemplified by this bill–legislation like this prohibits a doctor from evaluating the needs of her individual patients and customizing treatment based on those individual needs.
- Senate Bill (SB) 495 by Huffman establishes a maternal mortality and morbidity task force to review the rising number of maternal deaths in Texas and make recommendations to help reduce the incidence of pregnancy-related deaths and severe maternal morbidity.
- House Bill (HB) 15, by Rep. Lois Kolkhorst and sponsored by Sen. Jane Nelson establishes a Perinatal Advisory Council to develop a uniform statewide system for neonatal and maternal levels of care based on national practices. Mandating standards based on national best practices should improve the quality of care and reduce infant and maternal mortality. Additionally, improved data collection will allow the Department of StateHealth Services (DSHS) to better evaluate changes in health outcomes.
- HB 1605 by Rep. Sarah Davis and sponsored by Sen. Joan Huffman creates a pilot program in Harris County to provide a pregnancy home and maternity care management to women enrolled in the Medicaid managed care program. This new model of care ensures coordinated access to a variety of medical services that patients need to increase the number of healthy pregnancies.
The intrusion of HB 2 from the 83rd legislature, 2nd Special Session comes on top of interference in the doctor-patient relationship from bills passed in the 82nd Session:
- One law mandatsd that a specific statement be included in your mammogram report. While this may seem well-meaning, there was no scientific agreement about the information that must be included in the report. Rather than mandating a specific statement in the results, it would be better for you to discuss your results with your doctor. Your doctor keeps up-to-date on these issues and as the scientific information evolves, you can discuss the full picture of information with her in the office.
- One law mandates that a vaginal sonogram has to be performed, even if a woman does not want the test. The sonogram test is not needed for the woman’s health in many cases. The law mandates what the doctor must say during the sonogram and also mandates what you must do as the patient (listen to the doctor’s explanation and listen to the baby’s heartbeat). This is similar to a law passed in Virginia—but in that state women were very outraged about being forced to have such an invasive procedure and the law was changed to be an belly sonogram.
Your doctor wants to be able to continue to provide you with unbiased, medically accurate information free from political and personal agendas. But we can’t, if we lose the freedom to talk with you openly. We can’t provide you with unbiased, medically accurate information if you can’t come and see a doctor.
- Cuts to programs which provided health care to low-income women have caused clinic closures across the state. The 2011 Texas Legislature nearly destroyed the Department of State Health Service (DSHS)’s Family Planning program cutting a total of $73 million in funding. These cuts severely affected public hospitals, Federally Qualified Community Health Centers, and small specialty clinics around the state causing 60 facilities to close. Low-income women in many areas of Texas already face long drives, or even complete lack of access to birth control and health screenings.
The investments in family planning passed in this year’s budget will mean that access to family planning servicesmay be available to approximately the same number of clients in 2014-15 as in 2010-11, before the deep cuts of the 82nd Legislature.
- Increases state funding to the DSHS Family Planning Program by $32.1 million in state funding to replace Title X (federal) dollars awarded to the Women’s Health and Family Planning Assoc. of Texas (WHFPT).
- Provides a DSHS Primary Health Care Expansion of $100 million for the biennium for women’s preventive care. Of the $100 million, 60% is expected to go for family planning services, including contraceptive care, for women.
- Adds $71.3 million of state funding for the Texas Women’s Health Program. 90% of this is to replace lost federal funding, because of the “Affiliate Ban Rule” enacted in 2011. This funding maintains the Texas Women’s Health Program, but shifts the funding source from federal to state dollars.