The State of Employer-Sponsored Healthcare
A regularly updated resource from TAB — tracking the costs, policies, and decisions shaping healthcare for Texas employers and the workers they support.
The numbers Texas employers are watching
The latest data from TAB members, supplemented by national and state benchmarks.
This month in employer healthcare
A short note from TAB on what employers, legislators, and members should be watching right now.
The constraint on employer coverage in Texas isn’t willingness — it’s affordability. Heading into the 90th Legislature, holding the line on new mandates and restoring price transparency are the levers within the state’s control.
- Texas ranks 3rd nationally for insurance mandates exceeding federal minimums — and the state’s own cost-benefit analysis process for new mandates sits largely unused.
- More than half of Texas employers self-fund their coverage; preserving ERISA preemption is what keeps those benefits consistent across the workforce.
- Texas OIG and the Attorney General’s MFCU recovered nearly $600 million in FY2025 — proof the enforcement infrastructure works when it’s resourced.
Comments, testimony & commentary
Comments to agencies, testimony at hearings, and published commentary from TAB’s policy team and leadership.
Recent Op-Eds & Commentary
Congress to Decide on Extending Critical Health Coverage Benefits for Small Business Owners, Workers, and Entrepreneurs →Legislative Priorities & Session Recap
TAB’s 89th Legislative Session Healthcare Priorities →The bigger picture
A deeper look at one issue per edition — context for legislators, business case for members.
Affordability, not willingness, is the constraint
TAB’s 2024 Employer Healthcare Survey gathered responses from more than 200 Texas businesses across every sector and region, and the message was consistent: employers want to keep offering coverage, but the cost of doing so is rising faster than they can absorb. 85% say healthcare costs are climbing at an unsustainable rate, and for 51% that growth has already interfered with their ability to raise wages or add staff. A striking 34% now identify health benefits as their single fastest-growing cost — ahead of wages, at 30%.
The pressure isn’t purely market-driven. More than 56% of employers believe government regulation is pushing costs higher, and Texas currently ranks 3rd nationally for insurance mandates that exceed federal minimums. The state already maintains a cost-benefit analysis process for evaluating new mandates — TAB’s case to the 90th Legislature is simply to use it. A tool that exists but goes ignored is no tool at all.
What employers are asking for is concrete and broadly shared: a cost estimate before any new mandate passes (more than 90% support), public price disclosure by providers (76%), accountability for those charging far above the marketplace (79%), and the option of more affordable, flexible plans (73%+). Because more than half of Texas employers self-fund their coverage, preserving federal ERISA preemption is the foundation that keeps these benefits consistent statewide — the thing most worth protecting before anything new is added.
Texas employers want to keep offering coverage. The data shows the constraint isn’t willingness — it’s affordability. Holding the line on new mandates and restoring transparency are the levers the Legislature controls. — Findings Summary, TAB 2024 Employer Healthcare SurveyRead the Full Brief →
Don’t miss the next edition
The State of Employer Healthcare is updated regularly.
For Legislators & Staff
Need a briefing, data point, or testimony from a Texas employer? Contact our policy team directly.