According to the Legislative Budget Board (LBB), HB 1716 is not anticipated to have a significant fiscal impact on the state budget. The bill would allow Medicaid reimbursement for services provided by certain associate-level counseling professionals, such as licensed professional counselor associates, marriage and family therapist associates, and master social workers pursuing clinical licensure, at a reimbursement rate equal to 50% of what is paid to licensed psychiatrists or psychologists. While this may lead to an increase in utilization of services due to expanded provider eligibility, the fiscal note emphasizes that any associated costs are expected to be minimal.

The Health and Human Services Commission (HHSC) does anticipate some administrative updates, such as modifications to claims processing systems and provider enrollment procedures. However, HHSC believes that these changes can be managed within existing resources and will not require additional appropriations or significant new spending. Furthermore, the fiscal note projects that even though service utilization may rise, the lower reimbursement rate for associate-level providers could mitigate any potential increase in overall program expenditures.

Regarding local governments, the bill is not expected to impose significant fiscal implications. Since Medicaid is administered at the state level and reimbursed partially by federal funds, local units of government are not anticipated to bear additional financial burdens under this legislation.

In sum, while HB 1716 will modestly expand access to Medicaid-covered counseling services and involve minor operational updates at the agency level, it is designed to do so in a cost-conscious manner, without creating significant new fiscal commitments.

HB 1716 is a well-intentioned response to Texas’s mental health provider shortage, particularly among Medicaid recipients. It aims to address this issue by expanding the pool of reimbursable Medicaid providers to include associate-level mental health professionals who are still working toward full licensure. While this expansion may improve short-term access to care and help grow the behavioral health workforce pipeline, it introduces several long-term policy concerns that warrant a “No” vote from those who support limited government and fiscal restraint.

First, HB 1716 represents an incremental expansion of the Medicaid program—Texas’s largest welfare program—by broadening the definition of reimbursable providers. Although modest in structure, it reflects a continuing trend of expanding Medicaid services piecemeal, which cumulatively grows the scope of the state’s social welfare obligations. Over time, these changes shift expectations and funding priorities toward publicly funded health care, while moving further away from targeted, temporary support for the most vulnerable populations.

Second, the bill exposes taxpayers to the risk of rising costs. The fiscal note claims no significant financial impact in the short term, but this relies on assumptions about low utilization and internal cost absorption. If provider access improves significantly, as the bill intends, then utilization and total Medicaid expenditures are likely to rise. Even at a reduced reimbursement rate, this could lead to higher spending over time without any guarantee of corresponding offsets elsewhere in the budget.

Finally, the bill could inadvertently crowd out private sector and community-based mental health care by increasing the accessibility and attractiveness of government-funded services. This shift erodes incentives for nonprofit, faith-based, or direct-pay private models to compete in the mental health space, pushing Texas further toward a public-sector-dominated system of care. For lawmakers committed to limited government, taxpayer protection, and preserving private solutions, these concerns outweigh the potential benefits of the bill. Therefore, Texas Policy Research recommends that lawmakers vote NO on HB 1716.

• Individual Liberty: The bill expands the ability of Medicaid recipients to choose from a broader pool of mental health providers. It gives individuals more autonomy in selecting affordable, accessible care, especially in areas with limited access to licensed professionals. However, the expansion of government-funded services into areas where private or nonprofit care could otherwise operate raises questions about long-term dependence on state-sponsored options. Over time, this can subtly erode the role of personal decision-making by crowding out alternatives.
• Personal Responsibility: The bill supports the professional growth of mental health workers by enabling supervised associates to gain experience, which might be seen as encouraging career development and responsibility. For patients, though, expanding Medicaid-funded care could reduce incentives to seek treatment through private insurance, employer benefits, or direct pay models. It may encourage greater reliance on public assistance rather than personal or family resources to obtain care, potentially undermining a culture of individual and familial responsibility.
• Free Enterprise: By introducing a broader class of providers into the Medicaid reimbursement system, the bill increases the government’s role in setting market terms for mental health care. Although associate-level professionals are already part of the market, reimbursing them through Medicaid adds a layer of state-subsidized competition that private pay providers may not be able to match. Over time, this could distort market signals and reduce incentives for private innovation or expansion in the behavioral health sector. The pricing pressure created by state-subsidized rates (even at 50%) can suppress wages, drive consolidation, or disincentivize non-government-aligned practices.
• Private Property Rights: There is no clear or direct impact on private property rights. The bill does not involve eminent domain, land use regulation, or intrusion into private ownership. However, long-term expansion of state reimbursement systems can indirectly shift market dynamics that affect how private practices operate or compete.
• Limited Government: Although the bill doesn’t create a new program, it expands the scope of an existing entitlement—Medicaid—without structural reform or corresponding reductions elsewhere. This piecemeal expansion, even if fiscally modest at first, represents a step away from a limited-government approach. It also increases the administrative burden on the Health and Human Services Commission, requires policy updates, and creates precedent for future reimbursement expansions. All of this contributes to mission creep within state-run health services.

• SB 469 (Same As)