Federal Issues


Federal supplemental payments and health care programs have a significant impact on Texas’ health care safety net. The Texas Hospital Association actively monitors legislative and regulatory activities in Washington, D.C. and engages with the Texas Congressional delegation and state leadership to ensure that federal policy serves the needs of Texas hospitals and patients. THA tracks and will educate lawmakers in their effort to:

  • Study the factors affecting health insurance markets in Texas, particularly the individual market, including federal and state law. Make recommendations that would result in increased stability in the markets and enhance value and affordability for individual consumers and businesses. Examine what steps the state needs to take to allow out-of-state health insurance sales. In developing recommendations, consider the flexibility afforded to states by 1332 “state innovation” waivers, which allow states to:
    • Modify or eliminate tax penalties associated with individual and employer coverage mandates.
    • Modify requirements for benefits and subsidies.
    • Find alternative ways to provide benefit plan choices, determine eligibility for subsidies and enroll consumers. Senate Business and Commerce Committee
  • Assess the status of the health insurance market in Texas and opportunities to improve this market through waivers of federal law or other mechanisms. Monitor any changes in federal law that may affect these options. House Committee on Insurance
  • Monitor Congressional action on federal health care reform and reauthorization of the Children’s Health Insurance Program. Identify potential impacts of any proposed federal changes. Identify short and long-term benefits and challenges related to converting Texas Medicaid funding to a block grant or per capita cap methodology. Determine how Texas should best prepare for federal changes, including statutory and regulatory revisions, as well as any new administrative functions that may be needed. Explore opportunities to increase the state’s flexibility in administering its Medicaid program, including but not limited to the use of 1115 and 1332 waivers. House Committee on Appropriations


John Hawkins, senior vice president of advocacy and public policy, 512/465-1505

Jennifer Banda, vice president of advocacy, public policy and HOSPAC, 512/465-1046

Richard Schirmer, vice president of policy analysis, 512,465-1056

Carrie Kroll, vice president of advocacy, quality and public health, 512/465-1043

Sara Gonzalez, vice president of advocacy and public policy, 512/465-1596

Cesar Lopez, J.D., associate general counsel, 512/465-1027

Cameron Duncan, III, J.D., assistant general counsel, 512/465-1539