Texas Legislative Guide

The Sunset Advisory Commission recommended that lawmakers in 2015 consolidate the state’s five health departments into one “mega-agency,” a move the commission said would make Texas’ health bureaucracy less fragmented and more efficient. Kyle Janek, executive commissioner of the Health and Human Services Commission (HHSC), endorsed the recommendation.

But after a contracting scandal rocked HHSC early in the session, lawmakers slowed their roll. Instead, they decided to only partially consolidate the state’s health and human services system. 

Senate Bill 200 by state Sen. Jane Nelson, R-Flower Mound, combines three of the state’s five health and human services agencies — the Health and Human Services Commission, the Department of Aging and Disability Services, and the Department of Assistive and Rehabilitative Services. A recommendation to also consolidate the two other agencies — the Department of State Health Services and the Department of Family and Protective Services — would be left to lawmakers to consider next session.

Updated: May 28, 2015

Texas lawmakers invested millions of additional dollars in the 2013 legislative session to address a looming physician shortage, and this session was no different.

Lawmakers passed Senate Bill 18, which creates more residency slots for medical students to alleviate the state’s physician shortage. It also instructs the state’s Higher Education Coordinating Board to incentivize teaching hospitals to create residency programs and increase funding for programs for primary care doctors in rural areas.

The measure creates a $300 million endowment to pay for the programs in future years.

But legislative budget writers did not boost payments to primary care doctors who see patients on Medicaid, the joint federal-state insurer of last resort for the poor and disabled. In Texas, physician groups say Medicaid pays significantly below the cost of treating patients, making it unappealing for doctors to treat people in the program — and serving as a disincentive to go into the field. 

Updated: May 28, 2015

Under the Affordable Care Act, President Obama’s signature health law, Texas was eligible to receive more than a hundred million federal dollars to put more poor adults onto Medicaid, the joint state-federal insurer of indigent children and the disabled. Republican leaders here said there were too many strings attached, and that Texas would not participate in expanding a “broken” Medicaid system.

There were no successful legislative efforts in the 2015 session to overrule that sentiment. GOP lawmakers stood firm on that, despite news that billions of federal dollars for hospitals could be in jeopardy if the state didn't expand Medicaid to cover more low-income Texans. 

A Texas waiver — valued at $29 billion — that provides federal funding for hospitals expires in 2016. Federal officials called the state's health agency in April to say that Texas' reluctance to expand Medicaid will play into whether they will extend the waiver.

Updated: May 28, 2015

For years, Texas lawmakers have struggled for an answer to a pressing question about end-of-life care: Should families or medical professionals make the final decision to end life-sustaining treatment for a terminally ill patient?

Some want to prohibit physicians from discontinuing care against a family’s wishes, while others want to give patients and their surrogates more discretion, but preserve a physician’s ability to make a medical judgment to end treatment. Neither side made much progress this session. 

But lawmakers did pass what's referred to as "right to try" legislation, a bill that would allow terminally ill patients who have exhausted other treatment options to try experimental drugs that have passed at least the first of three FDA trial phases.

Updated: May 28, 2015