According to the Legislative Budget Board (LBB), the bill would have no fiscal implications for the State of Texas. This assessment is based on the bill’s nature, which authorizes nonprofit organizations to independently establish or participate in certain regional health care programs, specifically premium assistance programs that do not provide direct health care services or benefits. Because the bill does not mandate state involvement or funding and does not expand eligibility for state-administered benefits, it is assumed that any administrative or oversight costs can be absorbed by existing resources without additional appropriations.

From a local government perspective, the fiscal note states that no significant fiscal implication is anticipated for counties or other local governmental units. This is largely because the bill removes the requirement for county participation in specific nonprofit-led programs, potentially reducing county administrative responsibilities rather than adding to them. By decentralizing control, the legislation may relieve local governments of both direct operational costs and oversight burdens associated with premium assistance programs for small employers.

Furthermore, since these nonprofit programs are explicitly barred from offering direct health services or benefits, the bill avoids triggering costly regulatory or reimbursement processes that typically accompany publicly funded healthcare initiatives. As such, the bill is seen as a cost-neutral policy shift that may broaden access to affordable insurance assistance without placing new fiscal demands on the state or counties.

HB 2655 enables community-based nonprofit organizations to independently operate premium assistance programs, which help cover insurance premiums for employees of small businesses, without requiring approval from the commissioners court of a county. These programs do not offer direct health care services or benefits but instead subsidize the purchase of private, licensed insurance products, a model that has already proven successful and low-risk in practice.

The bill corrects a legacy requirement in Texas law that initially made sense when Three-Share health plans functioned more like quasi-insurance programs, often outside the scope of Department of Insurance oversight. However, as the bill analysis notes, many of these programs, such as TexHealth Central Texas, now operate solely as funding vehicles that assist with premiums for commercial insurance. Given their limited scope, the requirement for county-level approval is no longer a necessary safeguard and instead acts as a bureaucratic barrier to expanding affordable health insurance options for low-income workers and small business employees.

From a liberty standpoint, HB 2655 fosters Free Enterprise by expanding nonprofit-led options in the health insurance market and promoting private-sector insurance solutions. It supports Limited Government by eliminating redundant county-level oversight of programs that are already supervised by state agencies like the Texas Department of Insurance. Furthermore, the bill encourages Personal Responsibility by empowering workers to access and maintain commercial health coverage with the help of streamlined nonprofit programs.

By reducing regulatory hurdles while preserving appropriate state oversight, the bill enhances health care accessibility in a fiscally neutral and liberty-aligned manner. There are no significant fiscal implications for the state or local governments, and the legislation imposes no mandates or new taxes. As such, Texas Policy Research recommends that lawmakers vote YES on HB 2655.

• Individual Liberty: The bill enhances individual liberty by increasing access to affordable health insurance for employees of small businesses through nonprofit-operated premium assistance programs. These programs empower individuals to choose and maintain private insurance plans without direct government provision of health care. By removing unnecessary county-level gatekeeping, the bill removes a structural barrier that limited personal freedom to participate in nonprofit health access initiatives.
• Personal Responsibility: The bill encourages personal responsibility by enabling working individuals, especially those employed by small businesses, to take proactive steps toward securing private health insurance. Premium assistance programs reduce financial barriers without eliminating individual agency; beneficiaries must still select, enroll in, and manage their insurance plans. This structure supports the notion that individuals, not the government, are primarily responsible for their health care decisions.
• Free Enterprise: The bill strongly supports free enterprise by shifting health access efforts away from direct public services and toward subsidizing private market solutions. It fosters a competitive environment where nonprofit organizations and commercial insurers can collaborate to expand coverage options. By allowing nonprofits to operate these programs without local government approval, it enables greater innovation and responsiveness in the market for health care financing.
• Private Property Rights: While the bill does not directly impact private property rights, it indirectly reinforces them by preserving the autonomy of nonprofit organizations and small businesses to form voluntary arrangements for employee benefits without government interference. It respects the legal and operational independence of nonprofits as private actors in the health care marketplace.
• Limited Government: The bill exemplifies the principle of limited government by removing outdated statutory requirements for county commissioner court approval of certain nonprofit health programs. Oversight remains intact through the Texas Department of Insurance, but the bill eliminates duplicative and unnecessary layers of regulation. This streamlining respects constitutional limits on government involvement and promotes more efficient governance in public health policy.