Texas Legislative Update

Several House committees met last week to examine issues that will likely shape healthcare policy discussions ahead of the 2027 legislative session. The House Public Health Committee focused on telehealth, rural healthcare programs, EMS funding, and emerging healthcare technologies; the House Insurance Committee examined healthcare affordability and insurance mandates; and the Select Committee on Governmental Oversight discussed governmental immunity and the Texas Tort Claims Act. Together, the hearings provided an early look at the healthcare issues lawmakers appear most interested in addressing over the interim.

During a lengthy hearing before the House Public Health Committee, lawmakers explored both the benefits and challenges of telehealth. Witnesses highlighted how virtual care has expanded access to healthcare and reduced unnecessary emergency department utilization, while physicians raised concerns about online companies prescribing and shipping ketamine directly to patients' homes with limited oversight. The discussion reflected a broader effort to balance increased access to care with appropriate patient safety protections.

The Public Health Committee also reviewed implementation of the state's $1.4 billion Rural Health Transformation Program award, the largest federal rural health award received by any state. Witnesses praised the investment but emphasized ongoing challenges facing rural providers, including administrative burdens, staffing shortages, and the difficulty of navigating complex grant requirements. Similar concerns emerged during discussions of rural EMS funding, where providers described obstacles related to ambulance grant eligibility and equipment replacement programs. Throughout the hearing, lawmakers repeatedly returned to a common theme: ensuring rural communities have the resources necessary to sustain healthcare access and emergency medical services.

Artificial intelligence surfaced repeatedly during healthcare discussions, despite the absence of a hearing specifically dedicated to AI. Witnesses highlighted the use of AI-assisted stroke detection in rural emergency departments, Medicaid program oversight, and other healthcare applications. Legislators appeared interested in how AI can improve access, efficiency, and patient outcomes while maintaining appropriate physician oversight and accountability.

Meanwhile, the House Insurance Committee focused on healthcare affordability, including rising costs for small employers, health insurance mandates, and billing transparency. Stakeholders debated whether certain mandates increase healthcare costs unnecessarily or provide important patient protections, setting the stage for continued discussions as lawmakers prepare for the next legislative session.

The Select Committee on Governmental Oversight also examined governmental immunity and the Texas Tort Claims Act. Members noted that liability caps have remained largely unchanged since 1969 and discussed whether current limits appropriately balance governmental
accountability with protections for public entities. While no specific legislative proposals emerged from the hearing, the discussion could have implications for public hospitals, health systems, and other governmental healthcare providers.

As the next legislative session approaches, lawmakers are focused on expanding access to care, strengthening rural healthcare infrastructure, addressing affordability, evaluating emerging technologies, and examining accountability within the healthcare system. These themes are likely to continue surfacing as interim work progresses and preparations continue for the January 2027 session.

Healthcare by the Numbers

• $1.4 billion – Federal Rural Health Transformation Program award received by Texas, the largest rural health award in the nation.
• 200,000 – Telehealth visits conducted by Harris Health over the past 12 months.
• 78% – Harris Health telehealth patients who avoided an emergency department visit following their virtual encounter.
• 154 counties – Rural counties approved for ambulance grant funding through HB 3000.
• $65.45 million – Rural ambulance grant funding approved to date.
• 10 states – States that currently prohibit mail-order ketamine programs; Texas is not among them.
• 912 deaths – National deaths from 2019–2023 in which prescribed ketamine was present; 140 listed ketamine as a direct contributing cause, according to testimony,