HB 18

"🟩 HB 18 – A Step Toward Saving Rural Hospitals… But with Strings Attached

Texas has a rural healthcare crisis. Over 20 rural hospitals have shut down since 2010, leaving thousands without access to emergency care, maternal health, or even basic services. HB 18, recently signed into law, is the state’s attempt to stop the bleeding.

At first glance, it looks like exactly what rural Texas needs:

✅ Emergency and innovation grants for struggling rural hospitals
✅ Medicaid enhancements for OB/GYN and pediatric care
✅ A new Rural Hospital Officers Academy to train local leaders
✅ More telehealth to connect rural patients with pediatric specialists

Sounds great, right?

Here’s where we need to stay alert:
🔒 The entire structure is controlled by the state’s Health and Human Services Commission (HHSC)—not your local leaders.
⚖️ The funding formulas are vague, undefined, and created behind closed doors.
🧾 There’s no requirement for public reporting, community oversight, or independent audits.
🗳️ Your town could qualify—and still be passed over—without explanation.

Even the new “Rural Hospital Financial Vulnerability Index” sounds technical, but it’s not publicly vetted. HHSC decides who’s vulnerable enough to save, and who’s not.

So yes—HB 18 has potential. It’s a big move in the right direction if implemented fairly and transparently. But that’s a big “if.”

💡 Here’s what we need to push for next:
– Local representation in funding decisions
– Public audits of all grant allocations
– Community input in training programs
– Sunset provisions to review effectiveness after 2–3 years

Because if we don’t speak up now, we may find ourselves with one more headline that says “Texas tried to help rural hospitals… and failed.”

Support rural care. Demand real oversight.
Follow me to keep up with what Texas laws actually do—not just what they claim."