New Report and Legislation Tackle Rising Health Care Mandates in Texas

What’s New: A new report from the Texas Conservative Coalition Research Institute (TCCRI) highlights the unchecked growth of health care mandates and their significant cost impact on Texas businesses and families.

• To address this, Senator Paul Bettencourt and Representative Dennis Paul have filed SB 818 and HB 1906, creating a fiscal note process to assess health care mandates before they become law.

?Why It Matters: Texas leads the nation in health care mandates beyond Affordable Care Act (ACA) requirements, with over 50 state-specific requirements driving up premiums. While lawmakers exempt their own state-funded plans due to high costs, no such transparency exists for private sector mandates, leaving employers and families to bear the burden of rising health care costs.

The Numbers Don’t Lie:

• 13%: Premium increases in Texas following a record number of mandates in 2021.
• 29 states: Require upfront cost analyses for health care mandates, a process Texas currently lacks.
• Over 90%: Employers support requiring lawmakers to estimate mandate costs before passing them. (Source: Texas Association of Business 2024 Employer Healthcare Survey)
• Over 2/3rds: Texans favor requiring transparency on the cost impact of mandates. (Source: Texans for Affordable Healthcare 2024 Survey)

The Big Picture: Texas’ lack of a fiscal note process for health care mandates results in:

• Uncontrolled Costs: Employers face rising premiums, with mandates adding to their financial burden.
• Limited Transparency: Lawmakers lack the necessary data to understand the private sector impact of mandates.
• Policy Risks: Without checks in place, mandate costs escalate unchecked, impacting affordability and coverage.

?How It Works: SB 818 and HB 1906 will:

• Establishes the Health Impact, Cost, and Coverage Analysis Program (HICCAP) to provide Texas lawmakers with an independent evaluation of proposed health insurance mandates
• Use Texas’ All-Payer Claims Database (APCD) for comprehensive cost analyses.
• Publicly post reviews to promote accountability and informed decision-making.

Broad Support:

• Broad Support: Stakeholders across industries, including employers, health plans, and consumer advocates, back the push for transparency to protect Texans from rising health care costs.

Go Deeper:

• Explore the TCCRI report on health care mandates and their financial impact.
• Read TAHP’s Press Release and Mandate Problem Explainer
• Read NFIB and Texas Association of Business Press Releases
• Read Texans for Affordable Healthcare Press Release

The Bottom Line: Mandates are driving up health care costs for Texas employers and families. By establishing a mandate fiscal note process, Texas lawmakers can provide transparency, protect against unnecessary cost increases, and align with national best practices.