Help Make Healthcare More Affordable for Texas Businesses
As Texas continues to lead the nation in economic growth, one challenge continues to threaten our competitive edge: the skyrocketing cost of healthcare. To ensure future state policy decisions address this persistent challenge, the Texas Association of Business (TAB), has launched its 2026 Employer Healthcare Survey, and we need your voice.
Your input is critical. Whether your company currently offers health coverage or not, this survey captures real-world insights on rising healthcare costs, coverage decisions, the impact on your business operations, and the policy solutions that matter most heading into the next legislative session. Your responses will directly strengthen TAB’s advocacy efforts to make healthcare more affordable and predictable for Texas employers.
In 2022 and 2024 Employer Healthcare Surveys painted a stark picture of what Texas businesses are facing. In 2024, 85% of Texas employers told us that healthcare costs are increasing at an unsustainable rate, with 34% indicating that health benefits had become the fastest-growing expense in their business – surpassing even wages. Over half of surveyed employers reported that escalating costs directly interfered with their ability to raise salaries or hire new workers.
We know this is due, in large part, to a Texas-sized healthcare mandate problem. Despite being the top state for business, Texas ranks among the highest in the nation for healthcare mandates that exceed federal requirements, with businesses and their employees feeling the brunt of excessive regulation. Only 27% of small businesses are now able to offer health coverage, a steadily declining figure. Meanwhile, 16.6% of Texans remain uninsured – the highest rate of any state in the country. Session after session, costly mandates and restrictive regulations pile up, undermining the ability of Texas businesses to lower costs and offer workers and families affordable coverage.
Thankfully, in 2025, TAB and the Texas business community strongly supported HB 138, which created the Health Impact, Cost, and Coverage Analysis Program (HICCAP). This program brings a critical new layer of transparency to healthcare policy and cost, ensuring lawmakers can pursue data-driven legislative proposals and protect affordable coverage for both employers and families.
Last week, the Texas Senate Committee on Health and Human Services held a hearing on rising healthcare costs. Speaker Burrows has convened a Select Committee on Health Care Affordability during the interim.
Today, the Texas House Insurance Committee held a hearing on Health Benefits for Small and Midsize Employers in our state. Watch TAB’s full testimony below:
Clearly, healthcare costs are top of mind for policymakers as we head into the 90th Texas Legislative session, and we owe it to every patient, every business owner, and every employee who relies on their employer for health coverage to support and advance the right policies that will keep costs in check across every community in Texas.
At TAB, we have consistently called on the Legislature to require cost transparency for any proposal affecting employer health benefits. Now, we need to hear from employers about the persistent challenges facing your business when it comes to rising healthcare costs and burdensome mandates.
The 2026 Employer Healthcare Survey is completely confidential, reported in aggregate only, and takes just 8–10 minutes to complete. Your perspective will help TAB fight for meaningful reforms that lower costs and protect Texas’ economic competitiveness for generations.
Are you a Texas employer that offers health coverage to your employees and their families? If so, please e-mail TAB’s Director of Government Affairs, Faith Villarreal at fvillarreal@txbiz.org to learn how to participate in this year’s survey.
–Faith Villarreal, Director of Government Affairs, Texas Association of Business
###