HB 26

"🚨 HB 26: What Looks Like a Nutrition Bill—Is Actually a Medicaid Power Shift 🚨

Texas House Bill 26 says it helps pregnant women on Medicaid get access to nutrition counseling and meals. That sounds great. Who wouldn’t want better care for high-risk moms?

But here’s what the bill actually does behind the scenes—and why every Texan should care.

🔎 What HB 26 Allows:

Lets Medicaid plans offer “nutrition counseling” instead of other Medicaid services

Gives an unelected advisory board the power to decide what counts as “evidence-based” care

Creates a pilot program for pregnant women that includes medically tailored meals—without requiring public bidding or contract review

Lets managed care organizations (MCOs) pick private vendors to deliver those meals or services—with no competitive procurement

Sets no limit on how much those vendors can keep in admin costs

📉 What’s Missing:

No public oversight of who gets paid

No mandatory audits or pricing caps

No clear standards for what counts as “evidence-based” nutrition

No legislative control over spending—these programs can be paid for from existing Medicaid funds, bypassing the normal budget process

💸 Who Benefits:

Private nonprofits and nutrition vendors looking for Medicaid contracts

Insurance-style Medicaid plans (MCOs) who can swap expensive treatments for cheaper food-based services

Health foundations that support “food as medicine” and now have a foot in the Medicaid door

😶‍🌫️ Who’s Left Out or At Risk:

Most Medicaid recipients—only pregnant women in the pilot program qualify for meal support

Clinics and traditional providers who could lose patients when care is replaced with vendor-driven nutrition services

Taxpayers—because these contracts won’t be publicly reviewed or competitively awarded

📜 Why It May Be Unconstitutional:

It delegates control of public money to unelected advisory boards and private companies

It bypasses the Texas Legislature’s duty to directly approve how Medicaid money is spent

It risks violating constitutional safeguards on public fund control, vendor selection, and government accountability

This isn’t just about food. It’s about how Texas spends billions of public Medicaid dollars—and who gets to decide where that money goes.

⚠️ Good goals don’t justify bad governance. Helping pregnant women shouldn’t mean handing public funds to private vendors behind closed doors.

If we don’t speak up now, this kind of “pilot program” could become the model for how health services get privatized—quietly, permanently, and without oversight.

📢 Healthy moms deserve real help. But Texans deserve transparency, fairness, and public control over public money."