In March, Texas House Speaker Dustin Burrows (R-Lubbock) established the House Select Committee on Health Care Affordability, tasking a bipartisan group of lawmakers with identifying the market dynamics driving up medical costs for Texas families.
The committee, led by Chair James Frank (R-Wichita Falls) and Vice Chair Toni Rose (D-Dallas), will spend the legislative interim studying consolidation, lack of competition, and pricing opacity in the state’s healthcare system.
According to Texas 2036, the formation of this committee comes as healthcare affordability has become the primary financial anxiety for Texans, surpassing concerns over groceries and housing. With employer-sponsored health insurance premiums reaching nearly $27,000 annually—roughly one-third of the state’s median household income—policymakers are increasingly focused on structural reforms to realign market incentives.
In a new report, Texas 2036 says that the state’s healthcare market is currently hindered by high levels of consolidation; nine Texas metropolitan areas are served by only one or two hospital systems, effectively limiting patient choice. Research indicates that hospital mergers in these concentrated markets are associated with price hikes ranging from 6% to 18%.
Furthermore, the report finds when hospitals acquire independent physician practices, they often introduce “facility fees” that can cause medical bills to skyrocket without a clear explanation for the patient or the insurer. This market dysfunction has measurable consequences: approximately 63% of Texans report skipping or postponing some form of care in the past year due to expense, while nearly 30% have left prescriptions unfilled for the same reason.
To address these issues, the legislative committee has been charged with examining seven specific areas, including billing practices that keep employers in the dark and the barriers preventing small businesses from offering affordable coverage to their workers.
While the Texas Legislature previously funded the Texas All-Payor Claims Database to improve price evaluation, some advocates suggest that more work is needed to ensure billing transparency is fully realized.
The Select Committee on Health Care Affordability is expected to produce policy recommendations ahead of the next legislative session to increase competition and lower costs for both families and employers. Texas 2036 believes says that focusing on a “Healthy Markets” framework that rewards providers for high-quality, low-price care, the committee aims to ensure that Texas’ economic growth translates more directly into financial relief for its residents.
“Seeing the Legislature commit dedicated resources to understanding and solving this problem is exactly the kind of policy momentum Texas needs,” stated Alec Mendoza, a policy advisor for Texas 2036.