According to the Legislative Budget Board (LBB), HB 513 is not expected to have a significant fiscal impact on the state. The fiscal note states that any costs associated with implementing the bill are assumed to be absorbable within existing resources.

The bill’s potential costs would likely relate to covered health care facilities adopting and implementing a surgical smoke evacuation policy. However, the LBB does not identify any major new state spending, staffing needs, technology costs, or administrative costs. The note also does not characterize the fiscal impact as indeterminate or dependent on uncertain assumptions beyond the general assumption that costs can be absorbed.

For local governments, the LBB similarly anticipates no significant fiscal implication. The fiscal note identifies the Health and Human Services Commission as the source agency but does not project a significant state or local cost for the 2026–27 biennium or beyond.

Texas Policy Research recommends that lawmakers vote NO on HB 513 unless amended as described below. HB 513 addresses a legitimate workplace and patient-safety concern, but it does so through a statewide statutory mandate on covered health care facilities. The bill analysis states that surgical smoke can expose health care workers and patients to hazardous chemicals, carcinogens, viruses, and other risks, and that existing evacuation systems can mitigate that exposure. Those facts support the bill’s stated safety objective, but they do not resolve the liberty concerns created by the bill’s regulatory structure.

The bill would expand the scope of government by requiring hospitals and ambulatory surgical centers to adopt and implement a surgical smoke evacuation policy by January 1, 2026. It would also require use of a surgical smoke evacuation system during each planned operating-room procedure that is likely to generate surgical smoke. This does not create a new agency, new fund, criminal offense, or express rulemaking authority, and the bill analysis specifically notes that it does not expressly create a criminal offense or grant additional rulemaking authority. Even so, the bill moves state law further into facility-level clinical operations by prescribing an operating-room equipment and policy requirement for private and public facilities.

The bill does not appear to impose a significant direct burden on taxpayers. According to the Legislative Budget Board, no significant fiscal implication to the state is anticipated, and any costs associated with the bill are assumed to be absorbable within existing resources. The LBB also anticipates no significant fiscal implication to units of local government. However, “no significant fiscal implication” does not mean “no cost.” State-operated facilities may absorb implementation costs within existing budgets, and private facilities may pass compliance costs through to patients, insurers, employers, or other payors.

The bill does increase the regulatory burden on businesses. Covered hospitals and ambulatory surgical centers would have to maintain a compliant policy and use smoke evacuation equipment in covered procedures. The bill is narrower than a more prescriptive mandate because it allows a facility to use any surgical smoke evacuation system that provides protection based on the surgical techniques and procedures performed at that facility. But the requirement itself is still mandatory, and facilities may incur costs related to equipment, training, maintenance, workflow changes, procurement, and internal compliance.

The principal objection is not that surgical smoke mitigation lacks value. The concern is that House Bill 513 substitutes a statutory command for facility discretion, professional standards, accreditation processes, liability incentives, employment arrangements, and market-based decision-making. A limited-government framework should be cautious about turning specific health care operating practices into statewide mandates, especially when the bill does not include a hardship exemption, sunset provision, cost review, or clear prohibition on future agency expansion.

The bill should be amended to narrow the mandate and reduce its government-growth and regulatory effects. Meaningful amendments should replace the mandate with a voluntary safe-harbor framework, limit any requirement to state-operated or directly publicly funded facilities, add a hardship exemption or delayed compliance pathway for small and rural facilities, prohibit agencies from adding rules, fees, inspections, penalties, certification requirements, or reporting mandates beyond the text of the statute, and include a sunset or legislative review requirement to evaluate costs, compliance burden, and measurable safety outcomes.

As written, HB 513 advances a safety objective through a regulatory mandate that expands the scope of state control over health care facility operations.

• SB 490 (Same As)