Cap Recap: Hawkins Stresses Hospitals’ Needs in County Affairs Committee

Each week during the 2023 session of the Texas Legislature, The Scope’s Cap Recap will take a quick look at the previous week’s most hospital-relevant news under the Pink Dome in Austin.


Last week, THA sent its top-ranking voice to the House Committee on County Affairs to make sure that committee realizes the extent to which hospitals need help, and to praise the funding for those facilities allocated in the Texas Legislature’s early budget proposals for 2024-25.

THA President/CEO John Hawkins urged full funding of Medicaid during his committee testimony Wednesday, calling it “the best thing the Legislature can do to help us.” Indeed, the largely identical budget bills in each chamber – Senate Bill 1 and House Bill 1 – would maintain and even slightly increase overall Medicaid funding during the next two years. Hawkins also noted THA was still working on “some of the inflationary impacts on the rural hospitals, particularly in the outpatient space.”

He stressed the hospital struggles quantified in recent THA-driven reports on finances and workforce, such as the sobering finding by Kaufman Hall in late 2022 that nearly one in 10 Texas hospitals are at risk of closure. Among rural hospitals, Kaufman Hall found that figure spiked to 26%.

Hawkins also noted that along with full Medicaid funding, the budget proposal includes “some real resources … to address workforce,” including strong funding for the Nursing Shortage Reduction Fund and the Loan Repayment Program for Mental Health Professionals. He also advocated for one of THA’s biggest behavioral health asks of this session, which isn’t in the budget proposals but will need to be included as a budget vehicle to become reality: a waiver from the federal Institutions for Mental Disease (IMD) exclusion for Medicaid. That exclusion limits Medicaid inpatient behavioral health stays to a maximum of 15 days for adults 21 to 64. A state waiver from the IMD rule would greatly improve behavioral health coverage.

For hospitals, an encouraging postscript to Hawkins’ testimony came just before he left the witness chair, when committee member Rep. Tony Tinderholt (R-Arlington) lamented the contrasting financial straits between hospitals and health plans – which continue to report eye-popping profits.

“What should be concerning is, to me … the insurance companies are walking away with billions of dollars. Our rates are all going up, and now hospitals are looking like they’re going to close, and we’re seeing this trend with pharmacies and everything in the medical field, so it’s really disappointing to see,” Rep. Tinderholt said. “And I don’t know what the answer is, but we know what the problem is. I think it’s our job to try to find some solutions.”

THA Stands for Investigation Transparency

THA testified on two different bills in last Monday’s House Public Health Committee hearing, including a measure that would increase transparency on state investigations of hospitals.

Associate General Counsel Cesar Lopez, J.D., spoke on THA’s support for House Bill 49 by Rep. Stephanie Klick (R-Fort Worth). HB 49 would make final reports and outcomes of those investigations public. You can learn more about HB 49 in THA’s white paper on the bill and investigation transparency.

In the same hearing, Assistant General Counsel Heather De La Garza, J.D., testified on THA-spurred House Bill 112 by Rep. Donna Howard (D-Austin) to curb workplace violence, one of the central tenets of THA’s hospital workforce-bolstering agenda. The bill would require the creation of a workplace violence committee within hospitals – as well as annual workplace violence training – and would prohibit retaliatory action for reporting a violent incident. De La Garza called violence prevention “a priority for all Texas hospitals.” Recent THA survey results showed most Texas hospitals saw increased workplace violence severity since the start of the COVID-19 pandemic.

Bill Filing Finished

Friday marked one of the first milestone calendar days of the 2023 legislative session: the final day of bill filing. Now lawmakers, THA and other stakeholders can stop preparing – and/or bracing – themselves for what may come and concentrate on what lawmakers have filed.

Now that the final filings are in, THA is tracking around 1,000 bills that may have ramifications for health care and hospitals. Keep checking the Cap Recap on The Scope and at for updates on important hearings and legislation, and also stay abreast of session using THA’s other digital platforms as well: THA’s Advocacy App (available in the App Store) and THA’s White Papers & Reports page. And be sure to follow THA’s four social media accounts: LinkedIn, Twitter, Facebook and Instagram.