Texas Association of Health Plans

Most Texans with employer coverage are already in plans free from expensive Texas health insurance mandates. Their coverage is just as comprehensive, but often costs 19% less. Meanwhile, small employers and their workers are stuck on the other side, paying some of the highest premiums in the country.

Small Employers Are Paying for Texas’s Mandate Problem - Texas Association of Health Plans Part of TAHP's Affordability Series: What's Driving Up the Cost of Coverage What’s new: Most Texans with employer coverage are already in plans free from expensive Texas health insurance mandates. Their coverage is just as comprehensive, but often costs 19% less. Meanwhile, small employers and the...

Some providers are starting to offer real upfront prices.

Insurers are building plans that reward Texans for choosing the lower-cost, same-quality setting, including coverage models that cover shoppable services at a set price.

But more can be done.

In too many cases, providers can charge more simply because patients cannot see prices and have no incentive to shop around.

As a result, the same blood draw, the same scan, and the same follow-up visit can carry very different prices.

The problem is that when patients end up in the most expensive setting, the bill can double for identical care.

The biggest untapped opportunity to bring those health care costs down is not a new drug or a new technology.

It’s giving patients the tools and incentives to be smart shoppers. It is helping Texans get the same care they need at a more affordable price.

Shifting routine care to the right place could save the U.S. health system $471 billion over the next decade and lower premiums and out-of-pocket costs for every Texan.

💚 Texas Mutual Insurance Company is investing $8 million in 2026 community grants to support nonprofits serving Texas businesses, families, and communities.

Community Funding | Texas Mutual To support Texas communities, businesses and working families, Texas Mutual is committing $4 million through two Request for Proposal (RFP) initiatives in 2022.

Health care fraud is under a national spotlight. In the past year, the federal government has charged 324 defendants in the largest health care fraud takedown in U.S. history, and CMS launched a new initiative to stop fraudulent billing before it happens.

Health Care Fraud Is Wasting Billions. Texas Can Strengthen Tools to Stop It. - Texas Association of Health Plans Part of TAHP's Affordability Series: What's Driving Up the Cost of Coverage What's new: Health care fraud is under a national spotlight. In the past year, the federal government has charged 324 defendants in the largest health care fraud takedown in U.S. history, and CMS launched a new initiative to...

Health care costs are now Americans’ number one concern. Hospital prices are a major reason why. Hospital spending drove 40% of health care spending growth from 2022 to 2024.

Addressing Affordability Starts with Hospital Prices - Texas Association of Health Plans Part of TAHP's Affordability Series: What's Driving Up the Cost of Coverage What's new: Health care costs are now Americans' number one concern. Hospital prices are a major reason why. Hospital spending drove 40% of health care spending growth from 2022 to 2024. Keep it simple: When hospitals charge...

Health care costs are rising faster than inflation, putting pressure on the cost of health insurance.
Hospital services, physician care, and prescription drug prices continue to increase, driving higher health care spending across the system.

By the numbers: 28% upcoding increase, 60% coded complex, $1.67B outpatient, 37% postpartum coding rise. Learn more about this topic at tahp.org

Texas employers face 7–9% premium increases this year; AI-assisted upcoding is quietly adding to the bill. Learn more about this topic at tahp.org