Doctors in Texas are watching a May 27 primary runoff to see if the Tea Party's call for full repeal will win over more nuanced calls from candidates seeking to make changes to the ACA and the state Medicaid program.
“If the Tea Party sweeps those elections, then Medicaid expansion in Texas is going to be dead for a while,” said Dr. Austin King, an otolaryngologist from Abilene who was sworn in this month as president of the Texas Medical Association, the nation's largest state physician organization. “It's going to close the door on any discussion at all for the next couple of years.”
TEXPAC, the TMA political action committee, has endorsed 12 candidates (PDF) in the May 27 election: 11 Republicans and one Democrat. King said that because the GOP is so dominant in the state, “if you want to be a player,” you have to work with the Republicans. A TEXPAC election flier, however, has unchecked boxes next to Democrat and Republican labels and instead marks the box for the “Party of Medicine.”
A blog post on the TMA website notes that TEXPAC endorsed candidates who “fight government intrusion into the patient-physician relationship, support our liability reforms, work to improve the Texas Medicaid system and help us stand guard against public health threats.”
But King said those were not the only qualities the 47,000-member TMA sought in the candidates. “We're supporting candidates who will listen to us and bring us to the table,” he said.
Medicaid expansion and reform need to occur in Texas, he said, explaining that the current program seeks to control costs by pushing people into managed-care plans that offer low reimbursement to doctors and limit patient choice through narrow network panels.
Fixing the problems requires discussions that are currently impossible in the all-for or all-against climate, he said.
“It's really kind of depressing right now,” King said. “I talk to all kinds of groups—the cattlemen, the Rotary clubs—and it's hard to have a rational discussion about what's good or bad about the ACA. You're attacked from the right or attacked from the left almost immediately. It's been an interesting experience.”
King, however, is confident the climate will improve. “I feel the political process will eventually work itself out,” he said. “But in the meantime, it's pretty uncomfortable.”
Follow Andis Robeznieks on Twitter: @MHARobeznieks