Today, House Appropriation’s overflow room was overflowing.  Concerned citizens were lining up, some  in wheelchairs, to testify about the pain that the proposed budget cuts would inflict. In January, when Chairman Jim Pitts laid out his draconian budget proposal, he called it “a starting point.” But as the days wear on, it looks less and less likely that major improvements can be made. While some members of the Senate might be willing to look at an increase in registration fees and in the gas tax, House Speaker Joe Straus is telling people that “under no circumstances” will a tax bill be considered. And why would he advocate one?  As one senator reminded me today, why should lawmakers “fall on their swords” to support a tax bill that Gov. Rick Perry would veto, with glee? Soon, and then too often, we will hear lawmakers resorting to  that well-worn phrase signaling desperation: “You can’t put lipstick on a pig.” It’s going to be that kind of budget. While the House will pass the budget bill first, Lt. Gov. David Dewhurst has told confidants that he has a fall-back  budget plan that, while not pretty, spreads the pain around as evenly as possible.  The concept is simple: “vital” services keep their current levels of funding, with no adjustments for inflation, patient loads or school enrollment. It has a “Hail Mary” aspect to it, postponing most cuts until 2013, in hopes that the state’s economic growth will rebound and produce more revenue for the state treasury that year. Also today, Dewhurst laid out his legislative plan, which will be carried by Sen. Jane Nelson, to encourage change in Texas medical care delivery by protecting insurance companies and doctors’ and hospital groups from anti-trust charges. Proponents believe the legislation will save the state money by allowing the creation of new medical consortiums that can deliver better outcomes for less money.  But can the state count on savings in this biennium? It takes a while to get these reforms going and see their effects.  Republicans in Washington are complaining a lot about phantom savings in “Obamacare;”  don’t be surprised if Republicans in Texas use “phantom savings” to help balance the state’s budget.