Opinion: Addressing the Texas-sized Healthcare Mandate Problem for Employers and Hard-Working Texans

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Despite our state’s continued position as the top state for business, Texas grapples with some of the highest healthcare costs in the nation, ranking fifth overall. As a result, employer plan costs increased 16% in the last three years, forcing many businesses to drop coverage altogether. As a result, many hard-working Texas families are currently struggling to afford their children's medical care, often making painful sacrifices that jeopardize their health and financial stability.

Session after session, costly mandates and restrictive regulations pile up – undermining the ability of Texas businesses to lower costs and offer Texans affordable coverage. We have a Texas-sized mandate problem, ranking third in the nation for healthcare mandates that exceed federal requirements. As a result, private employers cover 50% of Texans, paying for most of their monthly premium costs. Meanwhile, 16.6 % of Texans remain uninsured – the highest rate in the nation.

This is just the tip of the iceberg; without urgent reform, we stand at the precipice of a full-blown health care disaster.

Small Businesses

Small businesses – the backbone of our economy – are disproportionately burdened by these mandates. Only 27% of small businesses are now able to offer health care coverage, a steadily declining figure. Additionally, Texas businesses are experiencing a 9% increase in health spending this year, making it harder to offer competitive employee benefits. Without immediate reform to curb excessive, outdated health care mandates and overregulation, the Lone Star State risks dismantling the very thing that makes our state great – a thriving business framework and unmatched opportunity. The Texas Legislature must act now before our bureaucratic red tape suffocates prosperity and leaves hardworking Texans behind.

This session, the Texas Legislature has the opportunity to begin reversing this troublesome trend by passing HB 138, sponsored by Representative Jay Dean (R-Longview). The bill introduces the Health Impact, Cost, and Coverage Analysis Program (HICCAP), a groundbreaking program designed to evaluate legislative proposals impacting Texas’ health care coverage.

This week, I testified in favor of HB 138, supporting the new HICCAP program to assess the financial impact of Texas health care legislation and bring cost transparency back to employers and Texas families:

» Glenn Hamer Testimony, HB 183

Texas already has the tools to bring back healthcare affordability to our hard-working residents. By utilizing Speaker Burrows’s ‍, which passed in 2021 and established the Texas All-Payer Claims Database (APCD), lawmakers have access to readily available data with vital information on the legislative impacts mandates have on employers and families. By leveraging both APCD and the newly introduced HICCAP, Texas can bring pivotal transparency to health care policy and cost, ensure data-driven legislative proposals and protect affordable coverage for both employers and families. The tools are in place – now it’s time to use them.

HB 138 offers a bold opportunity to dismantle outdated, counterproductive policies that inflate costs and burden employers and families. This bill is a necessary step toward cutting through bureaucracy, eliminating unnecessary mandates and restoring affordability to our healthcare system.

We know that Texas’ status as an economic powerhouse is no accident – it is built on pro-business policies that attract employers here like a magnet. However, rising healthcare costs threaten to erode our competitive edge.

Critical Choice

The 89th Texas Legislature has a critical choice: Take decisive action and adopt HB 138 or allow outdated policies to jeopardize the very prosperity that has made Texas the economic envy of the world. We must re-instill affordability, transparency and stability in our healthcare system and rekindle the ‘Texas Miracle’ that makes our state one-of-a-kind.

Glenn Hamer

President & CEO, Texas Association of Business

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