State: Policy Priorities


Now more than ever, Texas hospitals have proven themselves to be critical to the health and safety of Texas. Hospitals were tested and strained like never before throughout the COVID-19 pandemic, and they kept the lights on during a time of uncertainty and darkness.

Hospitals are open around the clock, caring for all Texans with emergency conditions, regardless of a patient’s ability to pay. Over the course of the pandemic, Texas hospitals tested, vaccinated and cared for millions while many entities had to shut down.

Unfortunately, this has come at a cost. The extreme toll on hospitals has far outpaced relief. Looking forward, it’s clear that the battle-worn hospital industry is in critical need of resources to heal and rebuild.

Texas hospitals advocate for the resources they need to continue their life-saving mission that has proven to be foundational in a public health emergency – and every day.

Texas hospitals support policies to help rebuild the state’s critical health care infrastructure to protect the state’s growing population.

Here are the 2023 state policy priorities for the Texas hospital industry:


  • Maintain state funding of health and human services programs, including Medicaid reimbursement rates for trauma, safety net and rural hospitals.
  • Targeted rural Medicaid payments to match state law and prevent additional rural hospital closures.
  • Increase state funding to ensure timely and appropriate access to inpatient and outpatient, community-based services and supports for Texans with a behavioral health diagnosis.
  • Maintain consistent funding for the state’s trauma care network.


  • Support increased state funding for physician, nurse, behavioral health professional and allied health professional training, retention and loan repayment programs to address severe workforce shortages and help care for a growing population.
  • Support continued health care workplace safety, retention and workplace violence reduction strategies to maintain a strong workforce.
  • Support funding to address increased staffing costs caused by the COVID-19 pandemic.


  • Support hospital reimbursement payments closer to the actual cost of services.
  • Support stability and maintenance of supplemental Medicaid payments to help cover billions in unreimbursed costs, and ongoing preservation of the Medicaid 1115 Waiver.
  • Support continuation of the current tax structure as necessary to adequately fund essential state services, including Medicaid and other health and human services programs.
  • Support statewide authorization and use of local or regional hospital provider participation funds to finance Medicaid hospital programs, defray uncompensated care costs and support access to care projects established under the Medicaid 1115 Waiver.
  • Oppose decreases in hospital reimbursements, including through the use of site-neutral payments.


  • Support efforts to increase the number of Texans with comprehensive health insurance.
  • Support approval of 12-month postpartum Medicaid coverage for new mothers and other Medicaid expansions.


  • Support funding to address behavioral health needs.
  • Support Medicaid coverage for adult behavioral health inpatient care beyond 15 days through a state waiver allowing removal of the federal prohibition on payments to “institutions for mental disease” for most adult inpatient care.


  • Support efforts to improve vaccination rates for vaccine preventable diseases.
  • Support expanded resources to allow the state and Texas hospitals to respond to current and future pandemics, natural and man-made disasters and emergencies.
  • Support expanded resources for public health data collection to assist in community protection and emergency response.
  • Support policies and legislation that address documented health disparities in access, morbidity and mortality, particularly among racial/ethnic minority groups and those of lower socioeconomic status.


  • Support payer policies that reduce red tape and improve patient access to care, including limits on prior authorizations and care location policies.
  • Support measures that remove overly burdensome utilization review policies, ensure robust insurance networks and strengthen access to and payment of emergency room care.
  • Support patient access to price transparency data and quality data for all health care providers.
  • Support increased payer accountability in contracting and payment policies, provider relations, and network adequacy.


  • Oppose legislation to repeal or modify limitation on non-economic damages and future medical damages.