Texas House Launches New Women’s Health Policy Push

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Texas House Speaker Dustin Burrows (R-Lubbock) is expanding the House’s interim agenda ahead of the 90th Texas Legislature, issuing six new Public Health charges that could lay the groundwork for legislation involving hormone testing, menopause treatment, health insurance, prenatal nutrition, existing state programs, and parental leave.

Burrows announced the supplemental interim charges on August 12 and referred them to the Texas House Committee on Public Health. He also asked Public Health Committee Chairman Gary VanDeaver (R-New Boston) to create a new Subcommittee on Maternal Health, Menopause and Access to Evidence-Based Medicine, chaired by State Rep. Katrina Pierson (R-Rockwall).

The new charges build on the broader slate of Texas House interim charges Burrows released in March 2026. Those earlier assignments directed House committees to examine policy issues ranging from property taxes and education to water, energy, regulation, government efficiency, and healthcare as lawmakers prepare for the 90th Legislative Session, set to begin in January 2027. The August announcement does not replace that agenda. Instead, it adds a more concentrated examination of women’s health policy to the House’s ongoing interim work.

The new subcommittee will also include State Reps. Elizabeth Campos (D-San Antonio) and Joanne Shofner (R-Nacogdoches).

The six charges represent a notably broad examination of women’s health policy, ranging from relatively narrow questions about access to iron supplements to larger debates over insurance coverage, hormone replacement therapy, and the appropriate role of state government in reducing healthcare barriers.

They also closely overlap with a Texas Women’s Health Initiative announced by Pierson, potentially offering an early look at legislation lawmakers could consider when the Legislature reconvenes.

Texas House Interim Charges Target Six Women’s Health Issues

The six supplemental interim charges give the House Committee on Public Health several distinct areas to examine.

Lawmakers are first directed to study opportunities for greater prevention and earlier detection of hormone imbalances, specifically including baseline reproductive hormone testing.

A second charge focuses on hormone replacement therapy, or HRT, for symptoms associated with perimenopause and menopause. The committee is directed to examine HRT coverage and recommend ways to expand access to physician-prescribed treatment. Significantly, the charge also asks lawmakers to review barriers that limit the ability of patients and physicians to choose what they consider the best course of care.

Another charge turns to health insurance administration, directing lawmakers to examine automatic insurance enrollment for newborn children as a way of reducing administrative barriers faced by new parents.

The committee will also study iron and other essential supplements during pregnancy, including ways to expand access to supplements, related testing, and prenatal nutrition. Separately, lawmakers are charged with evaluating the effectiveness of Healthy Texas Women and related state women’s health programs and identifying potential improvements for eligible Texans.

Finally, the House will examine parental leave policies for state employees, specifically whether additional leave should be available when a newborn is admitted to a neonatal intensive care unit.

While each issue could ultimately produce separate legislation, the charges collectively point toward a larger emphasis on preventive healthcare, reducing barriers between patients and physicians, and addressing gaps that can arise before, during, and after pregnancy.

Katrina Pierson’s Texas Women’s Health Initiative Offers a Preview

Pierson’s response provides additional insight into where at least some of these interim studies could lead.

On the same day Burrows announced the new charges, Pierson unveiled what she described as the Texas Women’s Health Initiative, a legislative package centered on prevention, early detection, treatment access, and protecting the physician-patient relationship.

“For decades, women have been used by special interests looking to score political points, while many of the everyday health issues affecting women remain unresolved,” Pierson said in announcing the initiative. “We are setting aside the discussions on abortion, birth control, and IVF to focus on health issues that impact all women across Texas.”

Her proposal includes baseline reproductive hormone testing for women between ages 35 and 40, with earlier testing when medically indicated. It also calls for insurance coverage of physician-prescribed hormone replacement therapy, including testosterone when medically necessary, FDA-approved and legally prescribed compounded medications, follow-up laboratory monitoring, and non-hormonal therapies.

Other proposals include automatic newborn insurance enrollment, expanded pharmacy standing orders for iron and certain supplements, prenatal nutrition initiatives, and liability protections for physicians providing hormone therapy within evidence-based guidelines.

Pierson already serves on the House Public Health Committee and its existing Subcommittee on Disease Prevention & Women’s & Children’s Health. Her appointment to lead the new subcommittee therefore places her in a significant position to shape how these issues are examined before the next legislative session.

Texas Women’s Health Policy Has Evolved Over Several Sessions

Speaker Burrows’s new interim charges do not begin Texas’s debate over women’s healthcare. Lawmakers have spent several sessions changing maternal health programs, Medicaid coverage, Healthy Texas Women, newborn coverage, and other healthcare policies affecting women. More recently, that discussion has expanded into menopause and hormone-related care.

During the 87th Legislative Session (2021), lawmakers passed House Bill 133 (HB 133), which provided for at least six months of Medicaid coverage following pregnancy and made changes involving Healthy Texas Women intended to improve continuity of care. The legislation drew in part on findings from the Maternal Mortality and Morbidity Review Committee, which has played an important role in shaping Texas maternal health policy.

The Legislature went further in 2023 with House Bill 12 (HB 12), extending postpartum Medicaid coverage to 12 months. Lawmakers that session also considered proposals involving doula reimbursement, maternal mortality data, and changes to the Maternal Mortality and Morbidity Review Committee.

By 2025, however, the legislative conversation was beginning to extend beyond pregnancy and postpartum care.

Pierson filed House Bill 3814 (HB 3814), which would have required certain health plans providing prescription drug benefits to cover medications used to treat perimenopause or menopause. The bill never received a hearing in the House Committee on Insurance, but the issue it raised now appears directly in Burrows’s interim charges, which instruct lawmakers to examine hormone replacement therapy coverage and recommend ways to expand access to physician-prescribed treatment.

House Bill 3961 (HB 3961), authored by State Rep. Christina Morales (D-Houston), similarly proposed creating a state educational program dedicated to perimenopause and menopause. It was referred to the House Committee on Public Health but, similarly, never received a hearing.

Other recent legislation overlaps with different portions of the new charges. House Bill 3940 (HB 3940), authored by State Rep. Ann Johnson (D-Houston), addressed information surrounding Medicaid coverage for newborn children amid concerns about automatic enrollment. House Bill 26 (HB 26), authored by State Rep. Lacey Hull (R-Houston), authorized certain Medicaid nutrition-support services for pregnant women with chronic health conditions.

Healthy Texas Women has likewise been the subject of repeated legislative changes and appropriations decisions over several sessions. Burrows is now asking lawmakers to evaluate the effectiveness of that program and related women’s health services rather than simply assume that existing policy is producing the desired results.

The new charges therefore combine several different stages of Texas women’s health policy. Some issues, including maternal health, postpartum coverage, newborn enrollment, and Healthy Texas Women, have been before lawmakers repeatedly. Menopause and hormone treatment received more direct legislative attention in 2025 but remain relatively new areas of sustained legislative focus. Baseline reproductive hormone testing and additional parental leave for state employees with newborns in neonatal intensive care appear to represent newer additions to the discussion.

That history will matter as lawmakers prepare recommendations for 2027. In some areas, the question is whether policies enacted only recently are working as intended. In others, lawmakers will be reconsidering proposals that failed to pass last session. And in still others, the House is entering policy territory that has received considerably less attention in previous sessions.

Patient Choice Could Become a Major Part of the Debate

One of the most consequential phrases in the interim charges may be the direction to examine barriers limiting the freedom of patients and physicians to choose an appropriate course of treatment. That language could produce a policy discussion extending beyond whether a particular treatment should be covered by insurance.

If lawmakers identify state regulations that unnecessarily restrict physicians from providing lawful treatments, there may be opportunities to remove those barriers rather than creating new government programs. Similarly, expanding lawful avenues for patients to obtain supplements or other routine healthcare products could reduce costs and improve access without necessarily requiring greater government involvement.

Pierson’s proposal to expand pharmacy standing orders for iron and other supplements reflects that approach. Her broader initiative also emphasizes physician-directed treatment and reducing regulatory barriers.

That approach also aligns with the Texas Liberty Compact’s call to streamline and modernize the Texas Code. The Compact argues that outdated, duplicative, or unnecessary laws and regulations should not persist simply through inertia and calls for a systematic review of the state’s accumulated statutory framework. Applied to healthcare, that principle would mean examining whether existing state restrictions still serve a legitimate purpose or instead unnecessarily limit patient choice, physician judgment, competition, or access to care.

The distinction will matter as lawmakers translate the interim charges into legislation. Expanding healthcare freedom by eliminating unnecessary restrictions is fundamentally different from attempting to improve access primarily through new mandates, subsidies, or government programs.

Insurance Mandates Could Raise Cost Questions

Some of the potential proposals also create an unavoidable question about who ultimately pays.

Requiring health plans to cover baseline hormone testing, hormone replacement therapy, laboratory monitoring, or other services may improve access for patients who use those benefits. But insurance mandates do not make healthcare services free. Their costs can ultimately be reflected in premiums or otherwise distributed among policyholders and employers. That does not necessarily mean every proposed coverage requirement lacks merit. It does mean lawmakers should evaluate the cost of each mandate alongside its potential health benefits.

The same scrutiny should apply to automatic newborn enrollment. Reducing paperwork for parents, particularly immediately following childbirth, could address a genuine administrative problem. Lawmakers should nevertheless examine how such a system would operate, what obligations would be imposed on insurers, how parents would be notified, and whether families retain meaningful control over coverage decisions.

The broader policy objective should be removing unnecessary obstacles without creating new ones elsewhere in the healthcare system.

Preventive Care Arguments Will Face a Fiscal Test

Pierson is also framing preventive women’s healthcare as a fiscal issue. Materials accompanying her initiative argue that identifying hormone and endocrine conditions earlier could reduce the long-term costs associated with chronic illness, emergency care, hospitalization, and more complicated treatment later.

That argument could become particularly important as lawmakers consider proposals affecting Medicaid, state employee health plans, and other taxpayer-supported programs. But claims that additional spending today will generate government savings tomorrow should be subjected to measurable fiscal analysis. Preventive interventions can produce better health outcomes and, in some circumstances, reduce future costs. Policymakers should still require evidence that a proposed state expenditure or mandate is likely to achieve those results rather than assuming every preventive program eventually pays for itself.

The interim process gives lawmakers an opportunity to examine those claims before legislation reaches the House floor.

Existing Texas Women’s Health Programs Will Face Scrutiny

The charges are not limited to creating new policies. The House Public Health Committee has also been explicitly instructed to evaluate Healthy Texas Women and related women’s health programs and determine whether existing services can be improved. That review could prove particularly useful if lawmakers approach it as an examination of both outcomes and efficiency.

Before expanding government programs or creating additional ones, legislators can determine whether existing programs are accomplishing their stated objectives, where administrative barriers exist, whether services overlap, and whether taxpayer resources are being directed toward programs that produce measurable results.

That creates an opportunity for reform that does not begin with the assumption that additional appropriations or new bureaucracy are necessary.

NICU Parental Leave Raises a Different Policy Question

The final charge stands somewhat apart from the others because it concerns Texas as an employer rather than healthcare regulation generally. Lawmakers will examine whether state employees should receive additional parental leave when their newborn is admitted to a neonatal intensive care unit.

That study will likely require lawmakers to balance the extraordinary circumstances facing families with critically ill newborns against the fiscal and workforce consequences of expanding state employee leave benefits. Because the charge is specifically limited to state employees, it does not itself propose a statewide private-sector leave mandate. That distinction will be important if lawmakers eventually recommend legislation.

Texas Women’s Health Policy Could Be a Major Issue in 2027

Interim charges do not change Texas law. They direct legislative committees to gather testimony, examine existing policies, and develop recommendations that can inform legislation in the next session. Speaker Burrows’s original March interim charges already provided an early roadmap of issues likely to occupy House lawmakers heading into 2027. The supplemental Public Health charges now add a more defined women’s health agenda to that work.

In this case, the overlap between Speaker Burrows’s new assignments and Pierson’s Texas Women’s Health Initiative makes the potential legislative trajectory unusually visible.

Baseline hormone testing, HRT access, newborn insurance enrollment, prenatal nutrition, and reduced healthcare barriers are already being discussed as potential legislative priorities rather than merely abstract subjects for study.

The important question over the coming months will be how lawmakers choose to pursue those goals.

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