Why Texas Needs This Healthcare Initiative

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Texas families are paying some of the highest medical prices in the country, even when they have insurance. Hospitals struggle with unpredictable supply costs, medical pricing varies wildly for the same services, and families often have no idea what care will cost until after they receive it. This system burdens working families, seniors, veterans, teachers, and employers across the state.

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Rural hospitals are especially vulnerable. Many operate on thin margins, face unstable supply chains, and risk closure due to rising costs they cannot control. Emergency rooms are stretched, staffing shortages grow, and Texans in rural communities are forced to travel long distances for basic or lifesaving care.

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Texas can do better. Healthcare should be predictable, transparent, and affordable. This initiative strengthens the system by addressing cost instability at its source, reducing unnecessary markups, stabilizing hospital supply chains, and giving Texans clearer insight into what they are paying for.

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The Problem We Must Solve

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Texas does not control its medical supply costs. Hospitals, clinics, and emergency providers often pay dramatically different prices for the same supplies, equipment, and pharmaceuticals. These prices are negotiated behind closed doors, marked up multiple times, and passed directly to patients.

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Families experience surprise bills, hidden fees, and inconsistent pricing. Hospitals face unpredictable budgets and administrative complexity. Large suppliers and out-of-state intermediaries profit, while Texans pay more without clarity or protection.

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At the same time, rural hospitals continue to close because they cannot absorb rising costs or stabilize their operations. When a rural hospital closes, entire communities lose access to emergency care, maternity services, and critical health infrastructure.

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This initiative addresses the root causes of these problems by promoting transparency, stabilizing supply procurement, and reducing cost volatility across the system.

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The Texas Healthcare Solution

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Texas can lower medical costs and protect families by organizing healthcare purchasing and pricing around transparency, predictability, and voluntary participation.

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Instead of allowing hidden markups and fragmented supply contracts to drive costs, this initiative establishes a Texas-led framework that encourages fair pricing, stabilizes hospital operations, and gives families clearer insight into medical expenses.

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The solution is built on four pillars that put Texans first.

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A Cost-Plus State Purchasing Framework

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Texas establishes a statewide, cost-plus purchasing framework that hospitals, clinics, emergency services, school districts, and public health providers may voluntarily join.

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Through this framework, Texas negotiates directly with manufacturers and suppliers for medical supplies, equipment, and pharmaceuticals. Items are purchased at verified production cost with a small, fixed operating margin.

This approach:

• Eliminates hidden markups

• Prevents unexplained pricing differences

• Stabilizes supply costs

• Reduces operating pressure on hospitals and emergency providers

Participation is voluntary, and no hospital is required to join as a condition of licensure or operation.

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Transparent and Predictable Pricing for Families

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Texans deserve to understand the cost of care before receiving it.

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This initiative promotes clear, simple pricing for common medical services among participating hospitals and clinics. These include emergency visits, diagnostics, imaging, standard procedures, lab work, and primary care services.

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Predictable pricing allows families to plan for care, reduces surprise billing, and restores trust in the healthcare system.

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Any statewide pricing requirements beyond existing law would require legislative authorization.

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Rural Hospital Protection

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Rural hospitals face some of the highest operating pressures in the state. By lowering supply costs and stabilizing procurement, this initiative helps rural facilities remain open, staffed, and capable of delivering emergency and essential care.

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Stable rural hospitals mean faster emergency response times, preserved maternity services, and stronger local communities. Protecting rural healthcare access strengthens Texas as a whole.

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Reducing Waste and Administrative Burden

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Healthcare workers spend too much time navigating billing complexity, insurance disputes, and administrative inefficiency.

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This initiative reduces waste by simplifying purchasing, standardizing pricing structures, and lowering administrative overhead. Nurses and doctors gain more time for patient care instead of paperwork.

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A simpler system improves efficiency, morale, and patient outcomes without compromising quality.

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How the System Works

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The Texas Healthcare Independence Initiative operates through voluntary participation, pilot programs, and lawful state coordination.

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By stabilizing supply procurement, reducing hidden markups, and promoting transparent pricing, Texas creates a more reliable healthcare environment for hospitals and families.

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The system functions through four integrated components.

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1. Statewide Cost-Plus Purchasing

Texas negotiates directly with manufacturers and suppliers for medical supplies and equipment. Participating entities purchase items at cost plus a fixed operating margin.

This structure prevents excessive markups and allows hospitals and emergency providers to budget accurately.

2. Texas Medical Supply Catalog

A statewide catalog lists medical supplies available through the cost-plus framework. The catalog displays real costs, standardizes pricing, and reduces waste.

Hospitals in rural and urban areas gain equal access to fair pricing and reliable procurement.

3. Clear Prices for Families

Participating facilities post simple, predictable prices for common services. Families gain clarity before care is delivered, reducing fear and financial uncertainty.

4. Voluntary Hospital Participation

Hospitals choose whether to participate. In return, they gain:

• Lower supply costs

• Stable pricing

• Reduced administrative burden

• Improved budgeting

• Increased patient trust

As participation grows, the system becomes more efficient and cost savings expand statewide.

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Deployment Plan

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The initiative deploys in phases to ensure smooth adoption and measurable results.

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Deployment proceeds through voluntary enrollment, pilot programs, and lawful state coordination. Any elements requiring statutory authority or appropriations will be pursued through the Texas Legislature.

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Phase 1: Rural and High-Need Regions

Early participation focuses on rural hospitals and high-cost regions to protect emergency access and stabilize vulnerable facilities.

Phase 2: Urban and Suburban Expansion

The system expands to major hospitals, medical centers, EMS providers, and school health programs.

Phase 3: Full Catalog Adoption

Additional supplies and pharmaceuticals are added to the catalog, increasing purchasing efficiency.

Phase 4: Price Transparency Expansion

More facilities adopt predictable pricing for common services and procedures.

Phase 5: Statewide Stabilization

Texas maintains oversight to ensure pricing stability, supply reliability, and continued rural access.

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Funding and Stability

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This initiative is designed to lower costs without raising taxes.

Texas already spends billions on healthcare systems and emergency services. This initiative improves how existing dollars are used through negotiated savings, reduced administrative waste, and efficient procurement.

Any budget adjustments or long-term funding mechanisms will be pursued through lawful budgeting processes and legislative appropriations where required.

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What the Governor Can Do and What Requires the Legislature

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This initiative operates within the Texas Constitution and existing state law.

Under existing executive authority, the Governor can:

• Direct state agencies to coordinate healthcare purchasing strategies

• Establish voluntary frameworks and pilot programs

• Negotiate supplier contracts for participating public entities

• Promote transparency standards consistent with current law

The following require legislative authorization:

• Mandatory pricing requirements for private hospitals

• Creation of new statutory purchasing authorities

• Long-term funding structures or appropriations

• Regulatory changes beyond existing law

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Benefits for Texans

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• Lower and more predictable medical costs

• Stronger rural hospitals

• More stable healthcare facilities

• Less administrative burden on providers

• Fairer pricing across the state

• A healthcare system Texans can trust

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Closing Message

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Texas families deserve a healthcare system that is affordable, transparent, and dependable. This initiative protects Texans from inflated prices, strengthens rural hospitals, and restores confidence in the cost of care.

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By stabilizing supply chains and promoting clear pricing, Texas can lead the nation in responsible healthcare reform without sacrificing quality or local control.

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A healthier Texas is a stronger Texas. This plan puts families first and builds a system designed for long-term stability and fairness.