Texas Medical Association and the ACA: TMA's State Endorsees are Working Against TMA Too

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Last week, BOR brought to light the Texas Medical Association's hypocrisy on women's health and the Affordable Care Act–exposing the fact that the organization continues to endorse and fund candidates who actively undermine TMA's policy recommendations.

The articles elicited a response from TMA, who claimed that its endorsement decisions are based on far more issues than these two, supposedly justifying why the organization finds it acceptable to endorse and fund candidates who have regularly advanced legislation against TMA's policy recommendations. Though we invited TMA to respond to the facts we presented, we have heard nothing from them thus far.

We've continued to look into how TMA endorsees' behavior compares to the organization's policy recommendations, and have found even more instances of hypocrisy regarding the Affordable Care Act. It turns out that TMA-endorsed federal lawmakers are not the only ones working to advance a position that TMA does not support.

Though TMA's official stance is that it does NOT support a total repeal of the ACA, many of TMA's state-level endorsees are vigorously pushing for the law to be repealed.

These state lawmakers have written numerous press statements, op-eds, and even legislation that condemns the Affordable Care Act and seeks to undermine its implementation. As with the federal lawmakers, TMA has not commented on these efforts and continues to give money to the people actively undermining a law that TMA at least somewhat supports.

See which Texas legislators are contradicting TMA on the Affordable Care Act after the jump.TMA's official stance on the Affordable Care Act is to “Find It, Fix It, Keep It”–meaning TMA wants lawmakers to find the holes in the act, fix the problematic parts, and keep the good parts. It's clear that this is not advocating repealing the entirety of the law. In fact, on a separate page TMA lists the positive aspects of the ACA that improve insurance coverage and lower health costs as things the Texas Legislature should keep even if the ACA were repealed.

These recommendations haven't stopped many TMA endorsees from continuing to advocate for a total repeal of the law, without any exceptions for the provisions TMA says will “reduce the likelihood of [patients'] falling back onto the rolls of the uninsured.”

TMA endorsees have regularly sought to undermine the Affordable Care Act, yet TMA has continued to endorse these legislators without censure or even an explanation as to why undermining TMA on the ACA isn't enough to lose TMA's support.

During the 2013 government shutdown, 75 Republican Texas legislators sent a letter to the Texas Congressional delegation urging them “to do all that you can to defund Obamacare,” calling it a “budget-busting entitlement that will drive up the cost of insurance around the country.” Of the 75 lawmakers who signed the letter, 47 were endorsed by TMA in either 2012 or 2010. They included State Sens. Glenn Hegar and Ken Paxton and State Reps. Jodie Laubenberg, Linda Harper-Brown, Greg Bonnen, and Phil King, authors/sponsors of last summer's back-door abortion ban HB 2, showing that protecting the doctor-patient relationship isn't the only issue where they gladly oppose TMA.

During the January legislative hearings regarding the rules for ACA navigators, many of the same Republican state legislators wrote yet another letter decrying the Affordable Care Act. The letter, addressed to officials at the Texas Department of Insurance, began by stating, “The Affordable Care Act is an unmitigated disaster with wide ranging and costly ramifications for Texans.  The ACA must be repealed or defunded.” Again, most of the lawmakers who signed onto the letter were endorsed and funded by TMA. Many received money from TMA in 2013, such as State Senator Bob Deuell who received over $17,000 from TMA in 2013.

TMA hasn't just supported candidates who have gone against TMA after entering the legislature, it has even supported candidates whose entire campaign was premised on a policy TMA supposedly opposes. In 2012, Tea Party Republican Donna Campbell was the Republican candidate for SD 25. Much of her campaign was centered on her opposition to the Affordable Care Act. After the Supreme Court ruled the ACA was constitutional in June 2012, Campbell released a statement, calling the law “a threat to our quality of health care” and to the “American way of life.” She promised that if elected, she would “explore every possible avenue to slow down and halt the encroachment of ObamaCare on our freedoms.”

Despite this, TMA endorsed Campbell, a physician, and donated $10,000 to her campaign.

After her election Campbell, along with fellow TMA endorsee State Sen. Ken Paxton, authored SJR 5, a proposed state constitutional amendment that would have allowed Texas residents to forego purchasing health insurance without penalty, in direct violation of the Affordable Care Act. Not only did Campbell and Paxton's proposed amendment violate federal law, it went against TMA's recommendations regarding Texas' uninsured. TMA has written extensively about the negative impacts Texas' high uninsured rate has on health care, and has called on the Texas Legislature to keep the parts of the ACA that would help reduce the number of uninsured. SJR 5 was the only bill relating to the uninsured that Campbell filed during the 83rd Legislative session.

TMA has said that it bases its endorsement decisions on many complicated issues–if these legislators' actions are any indication, it's clear the Affordable Care Act isn't one of them.

The Texas Medical Association's endorsement choices are its own to make, prioritizing issues as it sees fit. Nonetheless, it is important to point out that TMA's credibility is severely undermined when it makes policy recommendations in favor of protecting the doctor-patient relationship or improving the quality of health insurance and then goes on to endorse the very same candidates who have endangered those things in the first place.

As we did last week, BOR invites TMA to respond with an explanation of its decision-making process in light of these facts.


About Author

Katie Singh

Katie grew up in Austin and has been involved in Texas politics since 2004. She has been a part of several campaigns, from state house races to working at President Obama's campaign headquarters in 2012. She loves public policy, public health, and tacos. Katie tweets from @kasingh19.

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