By: TAHP | Thursday, August 20, 2026

What’s new: AI could save Texas up to $15 billion a year in health care costs. Health plans are already putting it to work, cutting wait times, reducing administrative costs, and speeding up payments for patients across the state.

Why it matters: AI helps health plans prevent fraud and cut administrative costs. Those savings show up as more affordable health care coverage for Texas employers and families.

By the numbers:

• It’s helping Texans shop for lower-cost, same-quality care: One health plan’s AI tool identifies members likely to need a shoppable procedure, like an MRI or CT scan, in the next 30 days, and connects them to a better-priced option. An early pilot of 1,700 members saved $605 per person on average, and the plan projects $6 million to $30 million a year in savings for just one line of business.
• Members get the right person on the first call: AI reads how complex a call sounds right at the start and routes it to the right person immediately, instead of transferring someone from department to department. That means more members get their issue solved on the first call, without having to call back or wait on hold again.
• AI is clearing routine approvals almost instantly: OptumRx’s tool can approve a prescription prior authorization in under 30 seconds, and health plans have cut prior authorization requirements by 11% to 15% industry-wide. AI still can’t deny a request. Denials go to a person, as Texas law requires.
• Providers get paid faster: Aetna’s new AI tool speeds up processing on the complex claims that need a person to review by hand, cutting that time by more than a fifth. That means doctors and hospitals get paid sooner and spend less time chasing down claims.
• It’s helping catch fraud before a claim is paid: Health plans use AI to flag suspicious billing patterns before money goes out the door.
• It adds up to real affordability gains, not just a bigger bill: The U.S. health care system avoided $258 billion in administrative costs last year through automation, and more than half of health plans already use AI somewhere in that work.

What Texas should do:

• Don’t duplicate regulation: The Texas Department of Insurance already has sole authority over regulating insurance. A second layer of regulation and mandates on top of that only slows down tools that are already working.
• Take a risk-based approach: Regulate the decisions that carry real risk to patients, like a coverage denial, not the everyday use of AI to speed up routine approvals and payments.
• Preserve the flexibility that’s working: Texas already regulates prior authorization, payment timelines, and appeals. Health plans should be able to keep using AI within those rules, not lose that flexibility to a broad new mandate.
• Preserve the ability to fight fraud, waste, and abuse: Texas law already protects the use of AI to catch fraud before a claim is paid. Lawmakers should keep that protection in place so health plans can keep finding fraud, waste, and abuse before it drives up costs for everyone.

What’s next: TAHP Vice President Blake Hutson testifies before the Texas House Public Health Committee today on the interim charge studying AI in health care.

• His message to lawmakers: protect the flexibility health plans need to keep using AI to lower costs and reduce administrative burden, instead of regulating it away.

The bottom line: AI is already helping hold down health care costs in Texas, without cutting corners on care. Lawmakers should protect that progress, not put it at risk.