According to the Legislative Budget Board (LBB) HB 4076, will have no significant fiscal impact on the state. The LBB's analysis assumes that any costs associated with the bill's implementation could be absorbed within existing resources. This conclusion suggests that the tasks required by the bill—such as ensuring non-discrimination in organ transplant eligibility based on vaccination status and allowing healthcare providers to develop alternative risk mitigation strategies—do not necessitate additional funding or staffing.

The primary agencies involved, including the Texas Medical Board and the Health and Human Services Commission (HHSC), are expected to integrate these requirements within their current operational frameworks. This indicates that the bill's enforcement and compliance measures are not anticipated to introduce substantial administrative or financial burdens on the state.

Furthermore, the LBB concluded that the bill would also have no significant fiscal impact on local governments. This suggests that local healthcare facilities and transplant centers would not require additional resources to comply with the bill's provisions. Overall, HB 4076 is considered fiscally neutral at both the state and local levels, as existing infrastructure and resources are deemed sufficient to accommodate the proposed changes.

HB 4076 upholds core liberty principles by emphasizing individual rights and personal autonomy in medical decision-making, specifically in the context of organ transplant eligibility. The bill addresses reported cases where patients were allegedly denied transplants or deprioritized solely due to their vaccination status, which raised concerns about fairness and medical ethics. By establishing clear legal protections against this form of discrimination, the bill ensures that transplant decisions are based on individualized medical evaluations rather than blanket institutional policies.

The bill supports individual liberty by prohibiting healthcare providers from denying or lowering priority for organ transplants solely based on vaccination status, unless a physician, following a personalized assessment, determines that the vaccination status is medically significant. This provision respects patients' rights while still allowing healthcare providers to exercise medical judgment when it is directly relevant to the transplant outcome. Furthermore, the bill includes protections for healthcare professionals, allowing them to develop alternative risk mitigation strategies and educate patients about vaccination risks and benefits, fostering informed decision-making without imposing vaccination requirements.

The bill is also consistent with the principle of limited government, as it does not introduce new criminal penalties or overly restrictive mandates. Instead, it grants rulemaking authority to the executive commissioner of the Health and Human Services Commission (HHSC) to ensure the bill's implementation aligns with healthcare standards. The Legislative Budget Board (LBB) has determined that the bill will have no significant fiscal impact on the state or local governments, as any costs can be absorbed using existing resources.

By balancing patient rights, medical judgment, and limited government intervention, HB 4076 appropriately addresses the need for fair and medically sound transplant eligibility criteria. Therefore, Texas Policy Research recommends that lawmakers vote YES on HB 4076.

• Individual Liberty: HB 4076 strongly upholds individual liberty by protecting patients’ rights to organ transplant eligibility regardless of their vaccination status. The bill prevents healthcare providers from using vaccination status as the sole criterion to deny or deprioritize individuals on transplant waiting lists. This ensures that decisions about life-saving procedures are not influenced by non-medical factors, thereby preserving personal autonomy. Additionally, by allowing vaccination status to be considered only when medically justified through an individualized evaluation, the bill respects both patient choice and the professional judgment of healthcare providers.
• Personal Responsibility: The bill promotes personal responsibility by ensuring that individuals are not penalized for their personal medical choices, such as opting out of vaccination. By safeguarding the right to fair medical evaluation, it reinforces the principle that individuals should be held accountable based on their specific medical needs rather than blanket policies. Furthermore, the bill allows healthcare providers to inform patients about risks and benefits of vaccination, empowering patients to make well-informed decisions about their health.
• Free Enterprise: HB 4076 has a neutral impact on free enterprise. While it places restrictions on how healthcare providers can consider vaccination status, it does not hinder the operation of transplant centers or the ability of healthcare providers to make medically sound decisions. By allowing for alternative risk mitigation strategies (like antibody testing or prophylactic treatments), the bill ensures that healthcare providers can maintain flexibility in their medical practices. This approach respects the professional autonomy of providers while also protecting patients from discriminatory practices.
• Private Property Rights: While not directly related to physical property, the bill indirectly supports the concept of bodily autonomy, which can be seen as an extension of private property rights. By affirming that an individual's vaccination status should not automatically affect their eligibility for organ transplantation, the bill respects the principle that one’s body is their own domain. This stance aligns with the broader notion that individuals should have control over their own medical choices without facing discriminatory consequences.
• Limited Government: HB 4076 adheres to the principle of limited government by avoiding the creation of new criminal offenses or imposing additional punitive measures. Instead, it grants rulemaking authority to the Health and Human Services Commission (HHSC) to ensure the bill's provisions are applied effectively. The bill's approach minimizes government overreach by focusing on preventing discrimination rather than mandating specific medical practices. Moreover, the Legislative Budget Board (LBB) determined that the bill will not incur significant costs, as existing resources are deemed sufficient to implement its provisions.