Health care price transparency in the 89th Lege: What got done
Background
Two proposals passed by the 89th Legislature have high potential to vastly improve health care price transparency.
FUNDING
The 89th Legislature appropriated over $9 million for the biennial operation of the All-Payor Claims Database, which collects health care claims information from insurers enrolling nearly 60% of insured Texans. Though the database was established in 2021, until now researchers have been unable to utilize the database to its fullest capabilities.
Texas 2036 has written extensively about the importance of the APCD as a tool to increase transparency here.
LEGISLATION
HB 138 by state Rep. Jay Dean, R-Longview, establishes the Health Impact, Cost and Coverage Analysis Program within the Center for Health Care Data at the University of Texas Health Science Center at Houston. This program will analyze the fiscal and health related impacts of proposed health coverage mandate so that policy makers have a comprehensive understanding of the anticipated outcomes of such proposals.
Outcome
Taken together, these proposals establish a strong foundation for developing more informed, effective and financially sustainable health plans across both the public and private sectors. This work is especially critical in the context of the state health benefit plans administered by the Teacher Retirement System of Texas (TRS) and the Employees Retirement System of Texas (ERS), which collectively cover approximately 1.25 million Texans — 750,000 under TRS and 500,000 under ERS.
Each budget cycle, these agencies must seek substantial appropriations from the Legislature to offset premium increases. During the 89th legislative session, they required nearly $1 billion combined additional funding above baseline just to limit annual premium hikes to 10%. This recurring and costly cycle poses a significant fiscal challenge.
However, with the All-Payor Claims Database (APCD) now fully operational and a program in place to analyze the cost impacts of services and mandates, policymakers have new tools at their disposal. These data-driven resources enable more precise targeting of reforms, paving the way for smarter plan design and improved outcomes for Texans — those enrolled in ERS and TRS plans, as well as in private market plans.