Legislative Interim Charges Add Health Care Affordability to Recurring Concerns
By Phil West and Amy Lynn Sorrel

The recently revealed roadmap for the Texas Legislature’s 2027 session indicates the Texas Medical Association could resume its battle against harmful scope-infringement and insurance bills and find opportunities to improve access to care through an emphasis on rural health and health care affordability.

“Folks are looking to physicians to come up with ideas, to bring solutions to the table to fix some of these challenges with health care,” said Jimmy Widmer, MD, chair of TMA’s Council on Legislation, of the work ahead of TMA in the upcoming session. “TMA and the advocacy team are taking a proactive approach to bring together a broad coalition of physicians and stakeholders, and to come up with real policy solutions and proposals proactively.”

The Speaker of the Texas House of Representatives Dustin Burrows and Lt. Gov. Dan Patrick, president of the Texas Senate, have released their interim charges for their respective chambers, instructing various legislative committees to study specific issues in between sessions.

As in past sessions, TMA will keep a close eye on how certain charges could impact physicians. Its preparatory work also will be shaped by the Sunset Advisory Commission’s current review of the Texas Health and Human Services Commission, Department of State Health Services, and the Maternal Mortality and Morbidity Review Committee.

On scope-of-practice expansion, TMA remains vigilant that interim charges on health care affordability and rural health don’t open the door to bills purporting to address those issues through scope expansions that jeopardize patient safety.

More specifically, TMA will monitor whether the House Committee on Public Health’s interim charge on telehealth will lead to renewed efforts allowing physicians and other health care professionals not licensed in Texas to offer telemedicine and telehealth services to Texans. The committee is directed to “evaluate the use of telehealth and virtual care models in Texas, including their impact on access, cost, quality, and patient outcomes, and recommend opportunities to modernize health care technology.”

Fraud, waste, and abuse, meanwhile, are listed as priorities across several committees, including the Senate Committee on Finance, the House Committee on Delivery of Government Efficiency and the new House Select Committee on Health Care Affordability. Additional assignments for the select committee include:

• Health care cost evaluation;
• How emerging financial models could reduce health care costs;
• How innovation in insurance plan design could improve affordability for consumers and employers while preserving access to care; and
• How consolidation impacts patient choice, market competition, and health care costs.

TMA submitted written testimony for the committee’s April 30 hearing. The panel, chaired by Rep. James Frank (R-Wichita Falls), includes two physician-legislators well known to TMA – Rep. Tom Oliverson, MD (R-Cypress), and Rep. Suleman Lalani, MD (D-Sugar Land).

“It’s nice to see that we have physician representation on that select committee,” said Dr. Widmer. “Who better to help articulate some of the challenges that are faced across the health care spectrum than physicians and physician-legislators?”

In response, Dr. Widmer, alongside about 20 other physicians, heads TMA’s own newly created health care affordability workgroup within the council to engage with the select committee and identify physician-backed solutions that align with its goals to potentially influence policy decisions considered in Austin next year. It’s unclear whether the legislature’s health care affordability select committee – created in March – will continue into the 2027 session.

TMA staff assess, however, that the select committee’s charges, plus those of the House Committee on Insurance, indicate legislators are concerned about the cost for employers providing insurance to employees – especially for small and midsized businesses.

Other insurance issues under the microscope of the House Committee on Insurance, Senate Committee on Business and Commerce, and Senate Committee on Health and Human Services, include:

• Implementing the 2025 Health Impact, Cost, and Coverage Analysis Program;
• Reviewing the prompt payment of insurance claims in Texas;
• Oversight of the Texas Department of Insurance;  
• Evaluating the use of artificial intelligence (AI) in the utilization review process; and
• Examining the drivers of rising health care costs (including insurance premiums) in Texas.

Among other committee charges that could impact medicine:

• Rural health care: The House Committee on Appropriations will study supporting and expanding rural health care, while the Senate Committee on Health and Human Services will study the implementation and impact of federal funding awarded to Texas per the Rural Health Transformation Program.
• THC: The Senate Committee on Health and Human Services will address the societal impacts of THC product consumption, including how it impacts health care costs.
• Social media: The House Committee on Public Health will study the impact of social media platforms and AI technologies on children’s mental health, cognitive development, and behavioral well-being.
• Abortion: The Senate Committee on State Affairs and Senate Committee on Health and Human Services will study the shipment of so-called “abortion pills” from other states to Texas, and health concerns tied to “the surrogacy and fertility industries in Texas,” respectively.

With interim hearings now underway, TMA also delivered testimony on April 30 in support of funding for disease prevention, maternal/infant health, and other public health services in the 2028-29 state budget.