By: TAHP | Friday, February 21, 2025

What’s new:  Texas is grappling with a surge in health insurance mandates and overregulation. 23 new mandate bills were passed in the last two legislative sessions, placing a heavy burden on employers and families.

Even worse: Texas is on track for more mandate bills filed than ever before in a legislative session. 82 mandate bills have already been filed at the State Capitol, and there are three weeks still left to go for bill filing.

Why It Matters: These mandates drive up health insurance costs, limit innovation, and force employers into one-size-fits-all plans. Small businesses are particularly affected, with only 27% now offering coverage — a number steadily declining due to rising costs and limited options.

The Numbers Don’t Lie:

• 23 new mandates were enacted in the last two sessions.
• Texas has the 3rd most mandates above ACA requirements in the nation.
• Texas has the 5th highest health care costs in the nation.
• Only 27% of small employers in Texas offer health benefits.

The Big Picture: Concerns over inflation and excessive government regulation are mounting across Texas — and health care is no exception. State and federal officials are beginning to question unnecessary and inefficient overregulation. The Texas House of Representatives established a new House Committee on Delivery of Government Efficiency (DOGE), sounding the alarm that overregulation is driving up costs for businesses and families.

• Outdated laws: Texas is stuck with outdated mandates — blocking patient rewards for lower-priced care, preventing value-based care models, and forcing families and employers to pay for higher-cost providers, even when lower-cost, high-quality options are available.
• Other states are taking action: North Carolina’s Senate has advanced legislation to pause new health insurance mandates, and federal policymakers continue to explore ways to balance coverage requirements with affordability and innovation.

Solutions to lower costs and modernize the market:

1. Pause costly mandates: Implement a moratorium on new health care mandates to prevent additional cost increases and give lawmakers time to evaluate their impact.
2. Bring transparency to the cost of mandates: Require fiscal notes on all proposed mandates, using Texas’ All-Payer Claims Database (APCD) to give lawmakers and the public clear data on costs to employers and families before legislation is passed. (SB 818 & HB 1906)
3. Reward patients for shopping smart: Allow health plans to offer lower copays and rewards when Texans choose more affordable, high-quality care — helping families save while encouraging competition. (SB 926 & HB 1959)
4. Give doctors more flexibility to care for patients: Remove outdated rules that block modern primary care payment models — upfront, predictable payments that help doctors spend more time with patients and reduce unnecessary costs. (SB 1014 & HB 2254)
5. Unlock price and quality information: Allow health plans to share provider price and quality data so families can compare costs and outcomes before choosing care — just like they would for any other major expense.
6. Protect small employers: Support policies that give small businesses more affordable, flexible coverage options to reverse the decline in small group health benefits.

The Bottom Line: Texas stands at a critical juncture. Without immediate reforms to curb excessive health care mandates and overregulation, the state risks further escalating costs and diminishing access to quality care. Implementing a moratorium on new mandates, enhancing fiscal transparency, and modernizing outdated regulations are essential steps toward a more affordable and innovative health care system for all Texans.

Solutions to Lower Costs

Learn More – Mandates