What the First Hearing Made Clear

The inaugural hearing of the Texas House Select Committee on Healthcare Affordability marked an important and timely step in Texas’ evolving healthcare conversation. Through testimony and discussion, committee members explored complex factors driving affordability challenges for Texas families, employers, clinicians, and communities. These included rising healthcare prices, market consolidation, administrative burden, insurance design, transparency, patient engagement, and growing strain across rural healthcare systems. The creation of the Select Committee under the leadership of Chairman James Frank reflects a growing recognition of the structural drivers of healthcare costs and patient burden, and that affordability has become both a healthcare and economic issue for Texans.  

A More Interconnected Affordability Picture

For years, affordability discussions nationally have often focused on individual parts of the healthcare system in isolation, such as hospitals, insurers, pharmaceutical pricing, or consumer transparency. The committee’s discussion suggested growing recognition that affordability pressures are being shaped by a more interconnected set of dynamics, including market structure, administrative burden, workforce shortages, fragmented delivery systems, delayed intervention, and uneven access to timely services across communities. At the center of much of the discussion was an increasingly important question:

How do we create a healthcare system that delivers greater value to patients and consumers rather than one primarily shaped around institutional incentives?

While prices, transparency, and competition matter, long-term affordability is also shaped by whether the healthcare system can reduce avoidable downstream costs through timely access, coordinated care, chronic disease management, and earlier intervention before health needs become more complex and expensive.

For example, Texas continues to face significant preventable disease burden. More than 1 in 10 Texas adults are living with diabetes, while nearly 32% report having high blood pressure. These two conditions are closely associated with avoidable hospitalizations, cardiovascular disease, disability, and rising healthcare expenditures. At the same time, many insured Texans increasingly face affordability challenges tied to deductibles, out-of-pocket costs, benefit complexity, and difficulty navigating fragmented systems of care.

The hearing also highlighted how fragmentation contributes to higher costs and patient burden. Across the healthcare system, disconnected care and administrative complexity can delay treatment, create inefficiencies, and drive up long-term costs.

This dynamic may be especially important in rural Texas, where affordability is often shaped not only by premiums or deductibles, but also by whether care is available locally and early enough to prevent escalation. Workforce shortages, provider instability, long travel distances, and limited access to coordinated primary and preventive care can increase both healthcare costs and broader economic strain on communities.

What Statewide Listening Revealed

As Texas continues this affordability discussion, one emerging consideration is whether sufficient attention is being given to the parts of the healthcare system most capable of reducing avoidable downstream costs over time. Timely access to coordinated primary care, behavioral health, oral health, and chronic disease management can help identify health concerns earlier, improve care coordination, reduce preventable complications, and avoid more costly care later. Recent statewide listening sessions and engagement efforts conducted by Texas Health Institute and the Texas Primary Care Consortium have consistently surfaced a broader insight across communities and stakeholders:

Healthcare affordability is shaped not only by the price of care, but also by whether Texans can access timely, coordinated, high-value care before health needs become more severe, fragmented, and expensive.

An Opportunity to Widen the Lens

The work of the Select Committee on Healthcare Affordability creates an important opportunity for Texas to examine not only the cost of care but also the broader conditions that influence why healthcare becomes expensive and difficult to navigate over time. As these conversations continue, Texas has an opportunity to advance a more comprehensive understanding of affordability, one that considers not only the price of care but also access, coordination, and the long-term impact of delayed care.