The Texas House Select Committee on Health Care Affordability held a hearing on Tuesday, September 1, to look for means of bringing down healthcare costs in the state.
Committee Chair James Frank (R-Wichita Falls) said in his opening remarks that Texas “overpays for healthcare” and said the incentive structure was to blame. According to him, “Prices lack transparency… customers are given little agency in shopping.”
He added that “no party has been able to decrease healthcare costs on their own… we must be able to work across party lines.”
Several witnesses touted the direct primary care (DPC) model, in which patients pay a monthly membership fee to a doctor instead of using health insurance.
Scott Burns, a witness representing the Direct Primary Care Coalition, said that while the DPC model can address “80 to 90 percent” of health issues, it “may not work” in rural areas, as it’s hard for them to compete for physicians against larger areas. In Burns’ view, the priority should be making it easier to get a practice up and running.
“It is so hard for us to find people,” he said, because of burdensome regulations and paperwork.
Lack of access to healthcare in rural areas has been an ongoing issue for the state. According to Rural Texas Strong, in 2024, one in five rural Texas counties “did not have a licensed primary care physician.”
Texas is set to receive $1.4 billion in federal funding over the next five years to be invested in major rural healthcare initiatives.
Another witness, Lane Aiena of Texas Academy of Family Physicians, agreed, saying smaller, independent practices were being squeezed by rising costs, paperwork, and regulations.
Hospital funding was also a major topic of discussion. John Hawkins, president and CEO of the Texas Hospital Association, testified that hospitals are bearing the brunt of increased costs. According to him, “[e]ven after the state’s supplemental payments, Texas hospitals absorbed $9 billion in totally unreimbursed Medicaid and uninsured costs in 2025 alone.”
Billionaire Mark Cuban, co-founder of Cost Plus Drugs, also spoke at the hearing and offered a five-point plan to bring down pharmaceutical costs. These were to “let patients shop, standardize the contracts, make the economics public, kill the gag clauses, and make repeat offenders face that actually matter,” he said.
“Do those five things, and Texas will save taxpayers, employers, and patients a lot of money,” Cuban said. “I guarantee it.”
Healthcare has featured in some of Texas’ statewide campaigns, with Gov. Greg Abbott and his gubernatorial opponent, state Rep. Gina Hinojosa (D-Austin), both discussing the issue in their affordability-centered race. State Rep. Vikki Goodwin (D-Austin), who is challenging Lt. Gov. Dan Patrick, has proposed creating a state-funded health insurance program using money from Texas’ Rainy Day Fund.