According to the Legislative Budget Board (LBB), the bill would result in a total negative fiscal impact of approximately $685,966 to General Revenue funds over the 2026–2027 biennium. The primary costs stem from the need for the Department of State Health Services (DSHS) to implement a new data-sharing process that provides death certificate information to Level I trauma hospitals to support their participation in Medicaid managed care programs​.

To carry out the bill’s requirements, DSHS would need to establish and manage data sharing agreements and memoranda of understanding (MOUs) with qualifying hospitals. This task would require hiring two full-time equivalent (FTE) positions—Program Specialist IV roles—responsible for coordinating hospital access to data via the State Health Analytics and Reporting Platform (SHARP). The cost of staffing these positions is estimated at $241,265 in fiscal year 2026 (due to a delayed start) and $301,180 annually beginning in 2027.

In addition to staffing, the bill necessitates technology modifications to SHARP to enable hospital access to the system. These one-time IT expenses are projected at $143,521 in FY 2026. The Health and Human Services Commission (HHSC) is expected to implement any necessary rulemaking within existing resources, thus incurring no additional cost. Notably, the bill is not expected to impose significant fiscal impacts on local governments.

Overall, while the bill introduces new operational responsibilities and associated costs, these are limited in scale and designed with discretion for expansion only when resources permit. This measured fiscal approach helps ensure compliance without placing undue strain on the state budget.

SB 1467 creates a narrowly tailored requirement for the Department of State Health Services (DSHS) to provide basic death record data to Level I trauma hospitals. This data sharing, limited to name, date of birth, and county of residence, is intended to improve hospital participation in Medicaid managed care and support better patient outcome tracking. The bill also authorizes DSHS, if resources allow, to expand this service to other hospitals.

Initially, concerns regarding the bill centered on its modest expansion of government through the addition of two new full-time equivalent (FTE) positions and its explicit alignment with the Medicaid program. However, upon closer review, it becomes clear that the bill serves a core government function: protecting taxpayer funds from waste and abuse within Medicaid. By providing timely and accurate mortality data, DSHS can help prevent improper capitation payments, halt unauthorized billing, and shut down potential identity fraud associated with deceased individuals. These safeguards align directly with the goals of fiscal accountability and program integrity.

Moreover, while the bill technically supports Medicaid operations, it does so not by expanding eligibility or benefits, but by increasing administrative efficiency and rooting out systemic waste—an appropriate and prudent use of government infrastructure. The bill also helps hospitals meet outcome reporting requirements, which in turn makes the delivery of Medicaid-funded care more accountable to taxpayers.

That said, the bill would benefit from amendments to ensure it remains tightly scoped and cost-contained. For example, clarifying language could limit expansion beyond Level I trauma facilities without legislative approval, and DSHS could be directed to prioritize internal efficiency before hiring additional staff.

In conclusion, SB 1467 advances responsible governance by strengthening Medicaid oversight, preventing fraud, and improving public data coordination, without significantly burdening private actors or expanding entitlements. With minor amendments to guard against future scope creep, Texas Policy Research recommends that lawmakers vote YES on SB 1467 and also consider amendments as described above.

• Individual Liberty: The bill does not restrict personal freedoms or impose new mandates on individuals. Instead, it facilitates more accurate and timely updates to health records when a person passes away, which can protect the dignity of deceased individuals and reduce emotional distress for families (e.g., by preventing unwanted medical bills or appointment notices). While not a direct expansion of liberty, these effects enhance the individual experience in dealing with healthcare and end-of-life issues in a respectful and orderly way.
• Personal Responsibility: The bill supports institutions (specifically hospitals and Medicaid administrators) in acting with greater responsibility and accountability. By ensuring providers have accurate mortality data, the bill helps prevent ongoing billing, prescription errors, or record inaccuracies. This reinforces the idea that public and private actors must be responsible stewards of sensitive information and taxpayer dollars. It does not shift responsibilities from individuals to the state, but helps ensure existing duties are performed accurately.
• Free Enterprise: Though the bill interacts with public healthcare infrastructure, it indirectly benefits private healthcare providers by improving their administrative systems. It helps hospitals more efficiently manage patient records, reduce erroneous charges, and avoid compliance penalties in Medicaid performance programs. This promotes operational efficiency and supports free enterprise within the healthcare sector by minimizing distortions caused by poor public data infrastructure.
• Private Property Rights: The bill has no effect on private property rights. It does not involve land use, asset seizure, eminent domain, or civil forfeiture. It does require the state to share public record data (death certificates) with certain hospitals, but these records are already collected under existing law and are not being commercialized or redistributed in a way that violates property or privacy expectations.
• Limited Government: The bill modestly expands government by requiring DSHS to implement a new data-sharing procedure and hire two additional full-time staff. This could be seen as an incremental expansion of state responsibilities. However, the purpose is to improve program integrity, prevent wasteful Medicaid spending, and streamline cross-agency operations—all consistent with a restrained and accountable government. Still, the open-ended authorization to expand data sharing to non-Level I trauma hospitals “subject to available resources” could lead to scope creep. Amending the bill to require legislative approval for future expansions would better uphold the limited government principle.