Legislation Details:

UPDATE: 6/12/2023 - HB 44 was Enacted, it was signed by Governor Greg Abbott on 6/12/2023 and is effective on 9/1/2023.

UPDATE: 5/30/2023 - HB 44 was sent to Governor Greg Abbott for signature on 5/30/2023.

UPDATE: 5/28/2023 - HB 44 was enrolled in the House on 5/28/2023.

UPDATE: 5/26/2023 - HB 44 as amended in the Senate was concurred by the House on 5/26/2023. 

UPDATE: 5/24/2023 - HB 44 was amended on the Senate floor and passed the 3rd reading as amended on 5/24/2023 by a vote of 18:12. The amendment stipulates that a provider is not in violation if the provider "1) adopts a policy requiring some or all of the provider's patients, including patients who are Medicaid recipients or child health plan program enrollees, to be vaccinated or immunized against a particular infections or communicable disease to receive health care services from the provider; and (2) provides an exemption to the policy described by Subdivision (1) under which the provider accepts from a patient who is a Medicaid recipient or child health plan program enrollee an oral or written request for an exemption from each required vaccination or immunization based on: (A) a reason of conscience, including a sincerely held religious belief, observance, or practice, that is incompatible with the administration of the vaccination or immunization; or (B) recognized medical condition for which the vaccinations or immunization is contraindicated." This amendment does not change our position of WATCH on the Bill.

UPDATE: 5/21/2023 - HB 44 was replaced with a committee substitute, which passed in the Senate Health and Human Services Committee  on 5/21/2023 by a vote of 8 Ayes, 3 Nays, 1 Absent. C.S.H.B. 44 removes the provision that would require HHSC to disenroll providers found not in compliance with the bill. Instead, the substitute authorizes HHSC to withhold reimbursement until the individual provider is in compliance with the bill's provisions. The bill also exempts providers specializing in oncology and organ transplant care services from the bill's provisions. 

This exception meant to coerce cancer and transplant patients into getting a COVID-19 vaccine is discriminatory. This provision could be used to deny patients who have not received the COVID-19 vaccine from receiving life saving care for cancer or for a failing organ. This denial of care for a vaccine that has proven to not stop transmission or infection of COVID-19 could amount to a death sentence for some patients who refuse the vaccine. Some of these patients may already have natural immunity which has already proven to be more robust than any protection from the vaccine. This section’s change is not supported by science. Denial of organ transplants over COVID-19 vaccination status is happening and should be stopped, not enabled. Recent article - https://www.theepochtimes.com/mother-of-7-denied-kidney-transplant-for-refusing-covid-shot-in-georgia_5212353.html.

Because of this change, NVIC is changing our position from SUPPORT to WATCH.  This change signifies a state policy endorsement of discrimination over COVID vaccination status for cancer and transplant patients dependent on Medicaid and CHIP who are mainly children.  This is really awful.  

This substitute also requires a title change to reflect the changes.  The old title was, "Prohibits Medicaid and CHIP providers from refusing to provide care to a participant based solely on vaccination status," and the new title reads, "Prohibits Medicaid & CHIP providers from refusing care to a participant based solely on vaccination status except for transplant & cancer patients."

UPDATE: 5/17/2023 - HB 44 was heard in the Senate Health and Human Services Committee on 5/17/2023, but the vote has not been posted. 

UPDATE: 5/10/2023 - HB 44 was heard in public hearing and left pending in the Senate Health and Human Services Committee on 5/10/2023.

UPDATE: 5/8/2023 - HB 44 is scheduled for a hearing in the Senate Health and Human Services Committee on Wednesday, 5/10/2023 at 8:00 am in the Senate Chamber. The agenda is here. 

UPDATE: 4/25/2023 - HB 44 was referred to the Senate Health and Human Services Committee on 4/26/2023.

UPDATE: 4/25/2023 - HB 44 passed third and final reading in the House by a vote of 93:54 on 4/24/2023.

UPDATE: 4/24/2023 - HB 44 was amended on the floor to only apply penalties to an individual physician who violates the section, and can't apply to other physicians who don't violate the section even if they are members of the same provider group.  This amendment does not raise any concerns and does not change our support for the bill.  Other amendments were offered that would have limited the bill's application to protect patients and those amendments failed. The bill passed second reading as amended by a vote of 93:51 on 4/24/2023.

UPDATE: 4/20/2023 - HB 44 is eligible for a floor vote in the full House and was placed on the General State Calendar for 4/24/2023.

UPDATE: 4/3/2023 - HB 44 was passed as substituted by a vote of 7 Ayes, 3 Nayes. The substitute includes a clarification absent from the introduced that the bill's prohibition against a provider refusing to provide health care services based on the recipient's or enrollee's refusal or failure to obtain certain vaccines or immunizations applies with respect to a provider's refusal based solely on the recipient's or enrollee's refusal or failure to do so.  This substitute does not change our position of support on the bill, but the title of bill was changed to add the word "solely" - "Prohibits Medicaid and CHIP providers from refusing to provide care to a participant based solely on vaccination status."

UPDATE: 3/20/2023 - HB 44 was heard in the House Public Health Committee on 3/20/2023 and was left pending in committee. 

UPDATE: 3/15/2023 - HB 44 is scheduled for a hearing in House Public Health Committee on 3/20/2023 at 8:00 AM in JHR (John H. Regan Building) Room 120.  See agenda here. 

Provide written public testimony here – https://comments.house.texas.gov/home?c=c410 

Register to present in-person testimony here – https://mytxlegis.capitol.texas.gov/HWRSPublic/About.aspx 

Public access to the John H. Reagan Building is available only through the east entrance.

You can watch live video/audio here - https://house.texas.gov/video-audio/ 

UPDATE: 2/15/2023 - SB 303 was referred to the Senate Health and Human Services Committee on 2/15/2023. 

HB 44 was filed on 11/14/2022 and is sponsored by Representative Swanson. SB 303 was filed on 12/19/2022 and is sponsored by Senator Bob Hall.

These bills would prohibit Medicaid and CHIP (Children’s Health Insurance Program) providers from refusing to provide care to a participant based on vaccination status and discriminating based on vaccination status by adding the following new Section 531.02119 to read as follows:

Sec.531.02119. DISCRIMINATION BASED ON IMMUNIZATION STATUS PROHIBITED.

(a) A provider who participates in Medicaid or the child health plan program, including a provider participating in the provider network of a managed care organization that contracts with the commission to provide services under Medicaid or the child health plan program, may not refuse to provide health care services to a Medicaid recipient or child health plan program enrollee based on the recipient ’s or enrollee ’s refusal or failure to obtain a vaccine or immunization for a particular infectious or communicable disease.

(b)The commission:

(1) may not provide Medicaid or child health plan program reimbursement to a provider who violates this section; and

(2) shall disenroll the provider from participation as a Medicaid or child health plan program provider.

(c) The executive commissioner may adopt rules as necessary to implement this section.

The new law would go into effect on 9/1/2023.  If a federal waiver is needed, then the effective date could be delayed until the waiver is granted.

Children on government assisted healthcare already have limited choices in covered healthcare providers. When providers refuse to give medical care to a child collectively in a geographical area based on vaccination status, this results in either no healthcare or coerced vaccination for the child. This is wrong for so many reasons but especially because Texas law allows for parents to refuse vaccination for their children with exemptions for either medical reasons or reasons of conscience including a religious belief.

Our tax dollars set aside to provide medical care for those who don’t have adequate insurance or can’t otherwise pay for the care should not be used to support coercing or forcing vaccination in exchange for care especially when Texas law allows parents to decline vaccination when they claim an exemption. 

NVIC supports legislation to prohibit discrimination based on vaccination status and this bill does provide protection for some.  There is a problem however with health care providers denying health care to everyone over vaccination status, and the legislature should consider prohibiting discrimination or refusal of care over vaccination status for all Texans.