In a Unique Session, THA Survives and Thrives

With its attention divided between Austin and Washington, D.C., during this year's session of the Texas Legislature, THA once again found success at the state Capitol.

June 17, 2025 | | Written by John Hawkins

There’s never been a legislative session quite like this one.

John Hawkins, President/CEO, Texas Hospital Association — Hawkins

Granted, in saying that, I’m only speaking for my time at the Texas Hospital Association, which now covers 21 years and 11 regular sessions of the Texas Legislature. But I can tell you that never, during any of those past sessions, did we have the usual 140-day firehose coming from the state Capitol accompanied by another, equally important blast of legislative reality hitting us from the northeast. That’s what we faced this winter and spring as we balanced our advocacy in Austin with the Medicaid implications of the federal budget reconciliation package – known as the “One Big Beautiful Bill” – that congressional Republicans are still pursuing in Washington, D.C., as of this writing.

With THA having to fervently represent Texas hospitals at simultaneous crunch times under two rotundas, we had our work cut out for us to make the 2025 state session a successful one. Yet, we were able to do it – and I can also say that in my two decades here at THA, I don’t think I’ve ever been prouder of our membership and our advocacy team.

With help from engaged members and other key trade associations, we opened the door to health care improvements all over Texas – and closed it to countless misguided policy ideas that threatened to take us backward on hospital operations and finances, public health and much more. We stood strong behind the Life of the Mother Act – an important clarification on the medical emergency exception to Texas’ abortion ban – and joined with the Texas Medical Association to get this exceptionally vital bill to the governor’s desk.

Among other achievements, our advocacy also netted a boost for state trauma and emergency medical services funding derived from traffic fine revenue; a requirement to notify hospitals before they get a visit from a violent criminal on parole who’s under electronic monitoring; an update to extend more help to providers through the state’s Loan Repayment Program for Mental Health Professionals; and restrictions on health insurers’ ability to potentially misuse artificial intelligence. And with the federal side of Medicaid funding dominating so much of the discussion in Washington, we avoided drastic cuts from the state’s end, as lawmakers held the line on Medicaid spending in the final 2026-27 budget. (At press time, all these measures were awaiting the governor’s signature except for the trauma/EMS funding bill, which Gov. Greg Abbott has already signed into law.)

On the flip side, anti-hospital and anti-science forces again found a willing audience and a strong tailwind at the Capitol, forcing us to defend institutional necessities that keep Texans healthy and Texas hospitals open – things like hospital vaccine requirements and the ability to charge facility fees at our outpatient departments. We didn’t stop every bad bill. But by and large, the legislation collectively representing large-scale damage to our ability to care for our patients was either defeated, mitigated by our work with bill authors behind the scenes, or both.

These successes would be satisfying in a normal session year. But of course, it wasn’t a normal year for us. Our advocacy team entered this session with new leadership at the top and multiple new additions to our lobby crew. Coming off a 2023 session in which hospitals became a prime target, we knew we had to spend the entire interim laying the groundwork to fortify ourselves against what was sure to be another tough go-round in 2025. We did so both within our walls and through public messaging that anticipated much of the action that unfolded between January and June.

Because of our work before and during these past four-plus months – all the meetings, calls, explainer documents, face-to-face meetings and more – Texas hospitals will remain on course to continue their lifesaving mission. Texas patients, and the state itself, will reap the benefits. If you were part of THA’s efforts in Austin between mid-January and sine die at the top of this month, give yourself a pat on the back. We’re indebted to your service.