Senate Budget Rider

TAFEC Opposes Senate Finance Committee Attempt to Limit Access to Emergency Care for Texans

Anti-Competitive Budget Rider Would Endanger Patient Health


On Wednesday, March 15, 2017, the Senate Finance Committee adopted recommendations from a cost containment budget work group that would negatively impact public health by reducing access to emergency care across the state.

The Senate Finance Committee voted to add a rider to Senate Bill 1, the Senate budget bill, which directs the Employee Retirement System (ERS) to “disincentivize member utilization of freestanding emergency rooms.” The rider would effectively shift a larger portion of costs for emergency care rendered at a freestanding emergency room to the enrollees of the ERS plan, including higher co-payments and deductibles, regardless of the facility’s network status.

This harmful budget provision has progressed all the way to the Budget Conference Committee. This is our last chance to contact our state elected officials to oppose this measure. Take action today!

Freestanding emergency rooms are fully functioning emergency rooms that are not attached to a larger hospital. These facilities provide the exact same level of service as hospital-based emergency rooms, and can treat true medical emergencies like heart attacks and strokes.  Freestanding emergency rooms are subject to state licensure, with safety and quality standards similar to hospital emergency rooms.

The American College of Emergency Physicians ranks Texas as 47th for providing timely access to emergency care. Freestanding emergency rooms help to improve access by offering an alternative setting to overcrowded hospital-based emergency rooms with shorter wait times.

It is not a stretch to predict that if the rider is passed, state employees who are injured or fall ill close to a freestanding emergency room would feel financial pressure to travel a longer distance to receive care at a hospital-based emergency room. Time is critical in medical emergencies, and the increased travel time could mean the difference between life and death, or serious and permanent injury or disability. This measure would discourage patients from seeking the immediate care they require, putting the lives of state employees at risk.

According to both state and federal law, emergency medical care is an essential health benefit, and must be provided without limitation – regardless of network status. This budget rider to “disincentivize” usage of freestanding emergency rooms is in direct violation of a patient’s ability to exercise their out-of-network benefit right. By shifting more costs to ERS patients through coinsurance and copayments, ERS is financially limiting the options available to its members and reducing access to care.  By targeting a small segment of the health care industry as the drafters of this rider have done, they mislead the public and harm small businesses that serve their communities.

Data considered by the work group clearly shows that freestanding emergency room billed charges – the lone variable that providers control themselves – are much cheaper than hospital-based emergency room billed charges. The ERS health plan was poorly managed by the insurer, which is why a new insurer has been awarded the contract beginning later this year.

Not only is this rider anti-competitive and illegal, it endangers the lives of thousands of state employees across Texas by limiting their options for care in the event of a medical emergency. TAFEC urges the Senate Finance Committee to reconsider this rider that ultimately hurts patients. Blaming providers and punishing ERS enrollees for a poorly managed health insurance contract is not the answer, and it will only lead to increased litigation for the state.

The Budget Conference Committee should seek cost containment through alternative measures that would not violate federal and state law or jeopardize the health of thousands of Texans throughout the state.

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