According to the Legislative Budget Board (LBB), SB 884 will have no significant fiscal implications to the State. The legislation directs health maintenance organizations (HMOs) and preferred provider benefit plans to establish incentive programs that reward enrollees for selecting cost-effective health care providers. However, the financial burden of implementation and administration falls on private insurers, not on state agencies or funds.

Major state agencies that were consulted, including the Texas Department of Insurance (TDI), Health and Human Services Commission (HHSC), University of Texas System Administration, Employees Retirement System (ERS), and Texas A&M University System Administration, all reported that they do not anticipate notable costs as a result of the bill. This likely reflects the bill’s focus on regulatory structure and market incentives rather than state-sponsored health coverage or public benefit expansion.

Additionally, there is no expected fiscal impact to local governments, further reinforcing that the legislation’s requirements apply to private insurers rather than publicly administered health plans or county-level health services. This limited financial footprint suggests that the bill is designed to encourage transparency and consumer cost awareness without creating new administrative obligations or funding needs for governmental entities.

SB 884 presents a constructive, market-oriented approach to reducing health care costs and empowering Texas consumers without expanding government control or public spending. The bill establishes a shared savings program that requires health maintenance organizations (HMOs) and preferred provider benefit plans (PPBPs) to reward enrollees who select more cost-effective health care providers, even if those providers are outside the traditional insurance network. By enhancing price transparency and aligning financial incentives with smart consumer choices, SB 884 creates a structure that encourages individual responsibility and market efficiency.

One of the most important considerations for evaluating legislation is whether it increases the size or scope of government. In this case, SB 884 does not do so. The bill does not create any new agencies or expand the role of state government in health care delivery. It delegates implementation to the private sector, specifically to health plans already under the regulatory purview of the Texas Department of Insurance. While the commissioner is granted rulemaking authority, this is routine and limited to ensuring the effective execution of the law within the department’s existing structure​.

Concerns about taxpayer impact are also minimal to nonexistent. According to the Legislative Budget Board’s fiscal note, there are no significant fiscal implications for either state or local governments. Key agencies, including the Texas Department of Insurance and the Health and Human Services Commission, confirmed that they anticipate no additional costs. Because the bill mandates private health plans—not public entities—to bear the costs of implementation and administration, it places no financial burden on taxpayers.

As for regulatory burden, SB 884 introduces targeted requirements for insurers—such as maintaining a public website and toll-free line for average pricing disclosure and establishing procedures to issue shared savings payments. These measures are modest and designed to foster competition and consumer engagement rather than impose bureaucratic hurdles. Insurers are given flexibility in how they deliver savings payments (e.g., cash, gift cards, premium credits), and the bill includes practical thresholds—such as exempting small-savings payments under $50—to reduce unnecessary administrative complexity.

In summary, SB 884 promotes liberty-aligned goals such as individual choice, personal responsibility, and free enterprise. It encourages patients to shop for better health care value and rewards them for doing so while allowing insurers to operate shared savings programs in a cost-effective and adaptable manner. It avoids expanding government or increasing taxes and instead facilitates private-sector solutions to rising health care costs. Given its fiscal prudence, policy alignment, and low regulatory footprint, Texas Policy Research recommends that lawmakers vote YES on SB 884.

• Individual Liberty: The bill empowers individuals to make more informed decisions about their health care by requiring insurers to disclose average contracted rates for specific services. This transparency allows patients to compare costs and choose care based not just on network status but on value and affordability. Patients also gain the freedom to use “direct pay providers”—those who operate outside traditional insurance networks—without forfeiting insurance benefits. These provisions collectively expand patient autonomy and choice in a system that often limits both.
• Personal Responsibility: By offering financial incentives to patients who seek out cost-effective care, the bill promotes active engagement in personal health care decisions. Enrollees are rewarded when they take the initiative to compare prices and select lower-cost providers. This shift encourages a more responsible and consumer-conscious approach to health spending, where patients share in the savings they help generate.
• Free Enterprise: The bill introduces competition into a space traditionally dominated by closed provider networks. By enabling patients to use direct-pay providers and still be eligible for insurer-sponsored incentives, the bill fosters a more dynamic marketplace. Health care providers who are willing to offer transparent, upfront pricing can now compete directly with in-network providers. This market-based mechanism aligns perfectly with the principles of free enterprise and consumer-driven innovation.
• Private Property Rights: The bill respects the right of providers to set their own prices and operate outside the traditional insurance system while also allowing patients to engage those providers with their own resources. Although the bill does not directly address property ownership or land use, it affirms the freedom of providers to transact directly with patients, which is consistent with respecting voluntary, contractual private relationships.
• Limited Government: The bill does not expand the role of government in delivering or financing health care. It imposes some new requirements on insurers, such as price disclosures and shared savings administration, but these are directed at improving transparency and are implemented by private entities. The Texas Department of Insurance may adopt rules, but no new bureaucracy or funding is created. This reflects a restrained regulatory approach that respects the principle of limited government.

• HB 5099 (Same As)