Cities across Texas are witnessing some of the country’s fastest growth. With this rapid change, it’s no wonder that Texas is becoming an innovation hub — with Austin dubbed the “new Silicon Valley.” Health care innovation is no exception. We’re seeing new business models rise (from Direct Primary Care practices to direct contract surgery marketplaces) hoping to introduce affordability, accessibility, and a patient-centered approach to a broken system.

But the private sector can’t transform the system alone. Our elected officials also have a role to play. Texas is a leader in passing laws that address surprise medical billing, promoting drug price transparency, and cracking down on emergency room price gouging. Just last year, a law passed in 2019 finally went into effect requiring insurers and health care providers to leave the patient out of billing disputes and negotiate prices for out-of-network care — setting a landmark standard for addressing issues of surprise billing across the country.

The 2021 legislative session provides lawmakers with another opportunity to tackle health policy concerns. But they’re faced with a somber agenda: Texas has the highest estimated number of uninsured citizens of any state. The counts are double the national average. While these numbers don’t account for the large population in Texas who get their care from insurance alternatives, such as health care cost-sharing organizations, these estimates are shocking and reprehensible.

As two professionals whose careers focus on advocating for a free-market health care economy, we believe a transformation of the system is imperative and long overdue. Transformation doesn’t happen overnight. But we must start somewhere. Here in Texas, we need common-sense measures that put power back in the hands of Texans immediately when it comes to their health.

The stage is set for legislators. On January 1, 2021, a new Federal Price Transparency Rule went into effect requiring hospitals to make their standard charges for items and services public. This rule will likely bolster consumer empowerment — meaning that patients could shop for the best deal in non-emergency health-related situations. You would never board a flight without knowing how much the airline ticket costs, so why should getting a standard medical procedure like an MRI be any different? 

But out of evaluated hospitals, only 2,000 hospitals nationwide have started to comply. The other 4,000 are dragging their feet. Many even tried to stop it from happening in the first place. Given that entrenched secrecy in pricing benefits large hospitals and traditional insurers, allowing them to charge as much as they would like, it’s no surprise that we’re seeing this scattershot approach to implementing reform.

The Texas Public Policy Foundation, in partnership with Health Cost Labs created a “Price Transparency Compliance Index” to objectively observe and compare state compliance with this Federal Rule. Only 46% of Texas hospitals have complied with the law at this moment in time, putting our state at the bottom half of the list.

Texas has the opportunity to change this narrative and start to lead the way. Representative Dr. Tom Oliverson, serving Texas’s 130th State House District, has filed a bill that would require Texas hospitals to post their prices.

And that’s a good start—but it’s only a start. Ideally, we should develop a system for medical services that allows consumers to easily shop for what they need—like Expedia does for travel.

We envision a future where Texans walk into their primary care doctor and ask for a menu of prices for each routine test and blood panel needed. Price gouging would significantly decline once providers are forced to show the wide discrepancies in prices to patients.

Ensuring hospital compliance with the new federal rule is a meaningful and impactful step Texas lawmakers can do right now that will immediately help Texans.

David Balat is the Healthcare Policy Director at Texas Public Policy Foundation, a former hospital executive and congressional candidate. Jamie Lagarde is the CEO of Sedera.