The Texas Public Policy Foundation’s Center on Health and Families campaign announced its policy priorities for the 2025 89th Texas Legislative Session. The campaign focuses on improving systems and outcomes that affect patients, families, and children.  CHF has worked on several successful reforms such as encouraging family formation, reforming child protective services, improving transparency in health care pricing, and expanding access to health care in rural communities.

“Healthy families are critical to the success of Texas,” said CHF Policy Director Tanner Aliff. “The state’s ability to implement reform faster than Congress means it can be a leader in reducing out-of-pocket costs, incentivizing more providers to come to Texas, protecting patients’ rights, and increasing physical access to high-quality care for everyone. America’s healthcare system has become more broken as more middlemen have gotten between patients and providers. Texas needs policy that ensures medical freedom and supports the relationship between a patient and their healthcare provider.”

“The Foundation is a leading voice for strengthening the family and transforming the state’s foster care system,” said Vice President of Policy Andrew Brown. “Our priorities for the 89th Texas Legislature reflect our belief that the nuclear family is one of society’s most important institutions and promote reforms that will make Texas the greatest state for raising a family.”

The Center on Health and Families campaign’s full legislative action agenda for the 89th regular session includes:

Make Affordable Healthcare More Accessible to Patients (“Charity Care”): Texas should ensure that nonprofit hospitals follow existing rules that require them to use the tax savings they receive from the state to lower healthcare costs for certain patients.

Improve Healthcare Price Transparency: Texas should strengthen prior-to-service price transparency, extend this transparency requirement to other care settings, and incentivize employers and patients to shop for healthcare services and health coverage.

Reform Grounds for Termination of Parental Rights: Termination of Parental Rights (TPR) is one of the harshest actions the state may take against a citizen. Texas should examine current grounds for termination of parental rights and enact legislation ensuring that the grounds are narrowly tailored and targeted to only those situations where termination is clearly necessary and appropriate.

Define Best Interest of the Child: Texas law lacks a clear definition of the “best interest of the child” standard, leading to ambiguity and inconsistency in its application and outcomes. The Texas Legislature should address this problem by providing a clear, overarching definition of “best interest of the child” for courts to apply.

Promote Marriage and Family Formation: Recognizing that strong, healthy families are the foundation of a strong, healthy Texas, the Texas Legislature should enact policies to promote marriage, ease the financial burden on families raising children, and strengthen the nuclear family. These policies should include a special focus on educating young Texans on the value of marriage and family formation.

Protect Patient Health Data Privacy: Establishing patient data ownership, accessibility, and portability for health data will support work begun in the 88th Texas Legislature with the Texas digital bill of rights. Texas should include data ownership that entitles a patient to an understandable and timely copy of their health records, as well as amending enforcement mechanisms by establishing information blocking as a violation enforced by Health and Human Services.

Reduce Barriers to Physician Licensing: To increase the number of licensed physicians serving Texans, the Texas Legislature should create an interstate telehealth registrant licensing pathway, create an alternative licensing pathway for American medical graduates who were not placed into a residency program, and allow international physicians to omit repeating an American residency so long as they have an offer of employment from a hospital.

Promote Marriage and Family Formation: Recognizing that strong, healthy families are the foundation of a strong, healthy Texas, the Texas Legislature should enact policies to promote marriage, ease the financial burden on families raising children, and strengthen the nuclear family. These policies should include a special focus on educating young Texans on the value of marriage and family formation.

Apply Active Efforts at Family Reunification: Recognizing the well-documented trauma caused to children by removing them from their families, Texas should amend the Family Code to require the Department of Family and Protective Services to apply the “active efforts” standard, as opposed to “reasonable efforts,” to every child who is the subject of an investigation or removal. By doing so, Texas can improve the quality of services intended to preserve and reunite families, reduce the number of children entering foster care, and minimize the time children spend in foster care.

Implement Child Welfare Licensing and Regulatory Reform: To reduce regulatory burdens straining the state’s capacity to safely and effectively care for children in foster care, Texas should consider and enact the most promising reforms recommended by the forthcoming third-party assessment of how Texas licenses and regulates child welfare service providers, foster homes, and adoptive families.

Implement and Expand Community-Based Care: Since 2017, Texas has been working to transform its foster care system by transferring primary responsibility for caring for children in the state’s custody to local community-based organizations. Texas should continue efforts to expand the Community-Based Care model to every region of the state while making data-based improvements to the model to increase local flexibility and ensure its long-term success.

Improve Mental Health Services: Texas should seek innovative ways to deliver mental and behavioral health services that are affordable and patient-centered.

End Anti-Competitive Contracting: To create a functioning healthcare market, the industry must be free from contractual language that reduces competition, restricts provider mobility, or prevents healthcare spending from being based on quality.

Reform Child Protective Services Reporting: Unfounded reports of child abuse and neglect can cause harm to innocent families while wasting valuable resources needed to protect children in actual danger of harm. Texas can better serve children and families by reforming mandatory reporter laws and creating an option for reporters to refer struggling families to community service providers who can help rather than CPS.

Reform Department of Family and Protective Services Central Registry: Texas should reform its child abuse and neglect central registry by prohibiting the listing of individuals prior to a court hearing determining their guilt or innocence.

Advance Family Mitigation and Diversion Laws: Texas should consider diversion laws that grant parents found guilty of nonviolent offenses priority access to programs like community-based alternatives to incarceration that have shown the ability to reduce recidivism.