Healthcare & Reproductive Health

Healthcare should not depend on whether someone lives in a major city or a rural community. My healthcare policy focuses on protecting rural providers, expanding affordable coverage, strengthening maternal and mental healthcare, and helping Texans build families through responsible infertility coverage.

Protect Rural Healthcare and Expand Access

Rural Texans should be able to get basic medical care without unreasonable travel or months-long waits. I support expanding access to affordable healthcare and protecting rural hospitals, clinics, physicians, nurses, therapists, and other providers who keep local communities healthy.

Expand Medicaid Responsibly

I support expanding Medicaid for eligible working Texans while the federal government continues to cover 90% of the qualifying cost for the expansion population. Expansion would add another coverage option. It would not require Texans to give up private, employer-sponsored, Medicare, military, or retiree coverage.

Before voting for expansion, I would require a current five-year fiscal analysis showing expected enrollment, administrative costs, verified savings, and how Texas would sustainably fund its share.

I would not raise property taxes or the state sales tax, cut public education or other essential services, or rely on speculative savings to pay for expansion.

If the federal contribution falls below 90%, Texas should reevaluate whether the program remains financially responsible.

Strengthen Maternal and Mental Healthcare

Texas should strengthen maternal healthcare and access to mental health services, especially in rural communities where providers can be scarce.

Patients should be able to receive timely care for miscarriage, ectopic pregnancy, and serious pregnancy complications. Doctors acting in good faith and using appropriate medical judgment should have clear legal protection to provide that care without dangerous delays.

Cover Infertility Treatment and IVF

Texas should begin by requiring state-regulated, fully insured large-group plans to cover medically necessary infertility diagnosis and treatment.

• Infertility testing and diagnosis.

• Fertility medications.

• Medically necessary surgery.

• Intrauterine insemination (IUI).

• In vitro fertilization (IVF).

• Intracytoplasmic sperm injection (ICSI).

• Egg retrieval.

• Embryo transfer.

• Medically necessary fertility preservation.

• Medically necessary genetic testing when there is a documented clinical indication, excluding preimplantation genetic testing for aneuploidy (PGT-A).

Treatment should begin with the least intensive medically appropriate option that has a reasonable chance of success. A patient should not be forced through lower-level treatment that the treating physician determines is unlikely to work simply to check a box before IVF.

Reasonable Coverage Limits

The initial benefit would cover up to four egg-retrieval cycles. After a live birth, up to two additional retrieval cycles could be covered if further treatment is medically necessary. Covered infertility treatment should be subject to comparable cost-sharing rules rather than being singled out for unusually high out-of-pocket costs.

Donor Conception and Gestational Carriers

Coverage may include donor eggs, donor sperm, and gestational-carrier arrangements when medically appropriate.

When use of a gestational carrier is medically necessary, the insurance benefit would cover the carrier's medical treatment related to the pregnancy. It would not cover compensation to the carrier, agency fees, legal fees, or other nonmedical surrogacy expenses.

Start With Texas Data

The first phase would apply to state-regulated, fully insured large-group plans. Texas should track utilization, premium effects, treatment patterns, denials, and patient cost-sharing so future expansion decisions are based on Texas data rather than assumptions.

After reviewing that experience, the Legislature could evaluate whether and how the requirement should expand to additional state-regulated insurance markets.

Bottom line: Protect rural healthcare. Expand coverage with responsible fiscal guardrails. Strengthen maternal and mental healthcare. Protect timely care for serious pregnancy complications. Require phased coverage of medically necessary infertility treatment, including IVF.