A Healthier State: THA’s Broad and Ambitious Priorities for the 2025 Texas Legislature

We’re now past the general election, and Texans across the state have cast their ballots, laying the foundation for the 89th Texas Legislature. We now know who will hold the 181 seats at our Capitol, meaning we’re one step closer to determining the next chapter of health care in Texas.

John Hawkins, President/CEO, Texas Hospital Association — John Hawkins

With a clear layout of the new Legislature that will begin its work on Jan. 14, 2025, the countdown has begun at the Texas Hospital Association to once again bring the needs of the Texas health care system front and center.

Texas hospitals stand as a shining example of excellence, and it’s critical that we provide them with the tools and resources they need to thrive. The needs of our hospitals vary depending on the communities they serve, and THA’s 2025 state policy priorities – our high-level roadmap for our efforts this session – are a reflection of this. This session, THA will impress these needs to the legislature, including the importance of ensuring financial stability, addressing workforce challenges and improving access to care and coverage.

Let’s start with one of our longest-standing and most important crusades: bringing Medicaid hospital funding closer to the cost of care. Last year, Texas hospitals provided at least $8.1 billion in uninsured care, with $3.1 billion ultimately going unreimbursed by supplemental payments. Hospitals across the board feel the impacts of this burden and pass along these costs to remain operational, resulting in higher taxes and higher commercial insurance premiums. As always, we are asking lawmakers to ensure Medicaid rates are more in line with our costs.

It’s also crucial that our Legislature support the stability and maintenance of supplemental Medicaid payments and ensure continuing Medicaid reimbursement for labor and delivery, trauma and safety-net add-on payments. We’ll also fight any attempts to decrease reimbursements or ban hospital outpatient payments, as the insurance industry attempted during the 2023 session.

Even after we passed some key workforce-related initiatives during 2023, that topic still occupies a prominent spot on our radar as well. We’ll continue our focus on curbing the bottleneck of the state’s nursing workforce training pipeline. We made progress in 2023 with the passage of Senate Bill 25, which established the clinical site nurse receptor grant program. To maintain that momentum, it’s critical that we support the program’s success with robust funding. We’ll also build upon our work last session by supporting strategies to bolster workplace safety, as well as increased funding for programs that curb other health care workforce shortages through training, retention and loan repayment.

It’s also crucial that we improve access to care by increasing the number of Texans with comprehensive health insurance. Our nation-leading uninsured rate – 18% by recent accounting – is unsustainable. The continuum of care in behavioral health – a key priority for us last year – still features key gaps that need closing, such as the current federal cap on most adult inpatient Medicaid behavioral health stays. We’ll once again pursue a state waiver from that cap, known as the “institutions of mental disease” exclusion.

Among other priorities this session, improving access to care also requires the removal of burdensome red tape – such as insurers’ prior authorization hurdles – and continuing to push for laws that will ensure robust insurance networks. And as always, THA will be a loud voice on behalf of feeding our state’s public health engine. We’ll support expanded resources to respond to both future pandemics and disasters, such as this state’s most recent widespread catastrophic event: Hurricane Beryl.

Each day, our hospitals are there for us providing high-quality care to all Texans in need, regardless of their ability to pay. Passing the right policies for our hospitals may not come easy this session – but our facilities’ fight to protect Texas is unwavering, and so will be our fight to protect their ability to do so.