State: Key Issues & Legislation


Every two years, Texas hospitals get less than five months to convince state lawmakers how to foster a better health care landscape in the Lone Star State. The 2023 session of the Texas Legislature is offering the Texas Hospital Association and its member hospitals their latest opportunity to move health care forward. Among THA’s key state-level issues for 2023:

  • Re-fortifying a depleted workforce will be paramount following the COVID-19 pandemic’s deleterious impact on hospital personnel numbers. THA is asking lawmakers to fund several key programs to help rebuild the workforce, including the Nursing Facility Loan Repayment Assistance Program. House Bill 901 by Rep. Stephanie Klick (R-Fort Worth) and Senate Bill 244 by Sen. Lois Kolkhorst (R-Brenham) would remove an annual cap of $7,000 in loan repayment assistance for nurses who work as faculty in a nursing degree program. The companion bills would also base the amount a nurse receives on the proportion of hours the nurse worked as a faculty member to the number of hours worked by a full-time nurse. Creating safer hospital facilities that have a plan in place to prevent workplace violence is also a must. House Bill 112 by Rep. Donna Howard (D-Austin) and its companion, Senate Bill 240 by Sen. Donna Campbell, MD (R-New Braunfels) require hospitals, nursing facilities and other settings to develop a workplace violence prevention plan.
  • The alarming state of behavioral health in Texas coming out of COVID-19 demands attention. THA is advocating for a state waiver from the federal “institutes for mental disease” (IMD) exclusion, an arbitrary limit that only allows coverage for a 15-day inpatient behavioral health stay for adults ages 21-64. Hospitals are also supporting full Medicaid coverage for partial hospitalization services and intensive outpatient therapy to give mental health patients access to a full continuum of behavioral health care services.
  • With a new report by Kaufman Hall showing nearly one in 10 Texas hospitals are at risk of closure, and nearly half operating in the red during 2022, THA is asking lawmakers to help facilities survive the continuing financial difficulties the pandemic has presented. Among other requests, hospitals are asking lawmakers to support hospital reimbursements closer to the actual cost of services, stability of maintenance of supplemental Medicaid payments to help cover unreimbursed costs and continued use of local or regional hospital provider participations funds to finance Medicaid hospital programs.

For more on THA’s policy priorities and issues affecting hospitals as the 2023 session unfolds, visit THA’s White Papers & Reports webpage.

Advocacy in Action

Listen to THA’s testimony to get the topline messages on the issues impacting Texas hospitals.