The Texas Medical Association (TMA) delivered testimony to the Senate Committee on Health and Human Services and the House Select Committee on Health Care Affordability offering a policy framework they say would curb rising health care costs for Texas patients and employers.
TMA Council on Legislation Chair Dr. Andrew James “Jimmy” Widmer detailed the mounting economic pressures created by high premiums, soaring drug costs, and increasing administrative complexity. Dr. Widmer emphasized that “Texas patients, employers, and physicians all feel the pressure of higher premiums, higher deductibles, rising drug costs, narrower networks, administrative complexity, and increasingly difficult access to timely care.”
To address these systemic burdens, the nation’s largest state medical society proposed six policy solutions for state lawmakers to consider ahead of the next legislative session.
First, the association urged state leaders to reduce administrative waste by strengthening the enforcement of prior authorization and utilization review reforms to prevent insurance companies from unnecessarily delaying needed patient care and prescriptions. Second, the framework calls on lawmakers to scrutinize the practices of pharmacy benefit managers (PBMs), specifically what TMA alleges is aggressive cost-shifting tactics and instances where PBMs switch patient prescriptions solely to maximize profits rather than to improve medical outcomes.
Third, the testimony advised the state to protect meaningful insurance coverage by pursuing innovative, lower-cost health plan designs paired with clear consumer disclosures and robust physician-patient protections. Fourth, the association asserted that lawmakers must strengthen physician autonomy and reject any legislation that increases administrative burdens or threatens a physician’s clinical decision-making, which is necessary to protect independent practice viability.
Fifth, Dr. Widmer’s testimony underscored the need to improve practical market transparency, arguing that rules should expand beyond simple “posted prices” to provide patients with clear, usable data regarding premiums, deductibles, insurance networks, and actual out-of-pocket costs. Finally, the framework suggested treating public health as a long-term affordability strategy by investing in better patient access to primary care, preventive care, behavioral health, maternal care, and chronic disease management to limit avoidable downstream emergency spending.
Ultimately, the association maintained that Texas should focus on policies that foster meaningful market competition and preserve access to physician-led care rather than rewarding corporate consolidation.
The legislative push mirrors a broader, bicameral effort by Texas lawmakers to tackle what policy experts describe as the top financial anxiety for families—surpassing the price of groceries, utilities, and housing. According to data compiled by the nonpartisan policy organization Texas 2036, average annual employer-sponsored family coverage premiums in the state have climbed to $26,993, a figure that swallows roughly one-third of the median household income in Texas.
Charles Miller, the organization’s director of health and economic mobility policy, supported the call for structural overhauls, asserting that prices are unsustainable because health care markets currently lack the transparency, competition, and accountability required to make them work for everyday consumers.