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2025 · Regular session · House bill
HB1612
An uninsured patient can request to pay a covered hospital directly, subject to limits tied to the hospital's insurance-related prices.
Official caption: Relating to direct payment for certain health care provided by a hospital.
Official report lists House author(s): Frank. This does not identify sponsors or amendment drafters.
Bill explanation published · Version and amendment review scope is stated below · Individual amendment records may not be separately annotated.
Bill highlights
Selected points from the published explanation. Follow each point to its source-linked context; conditions and limits may matter.
- An uninsured patient can request to pay a covered hospital directly, subject to limits tied to the hospital's insurance-related prices.
- This right applies to patients who are not enrolled in or otherwise entitled to coverage under a health benefit plan, as broadly defined in the act.
- These are alternative ceilings, not a promise of the lower of the two prices, and “25% greater” is not a 25% discount.
- The law expressly preserves charity care for which the patient otherwise qualifies or is entitled.
- HB1612 took effect September 1, 2025.
What does it do?
An uninsured patient can request to pay a covered hospital directly, subject to limits tied to the hospital’s insurance-related prices. The request must be made no later than 60 days after receiving the bill or other final accounting. The bill or accounting must tell the patient about this option. The hospital must accept the qualifying direct payment as full payment for its service. Final law.
This right applies to patients who are not enrolled in or otherwise entitled to coverage under a health benefit plan, as broadly defined in the act. It is not a general right for insured patients to bypass their plans. Covered hospitals are public or private institutions licensed under Health and Safety Code Chapter 241; ambulatory surgical centers licensed under Chapter 243 are expressly excluded. The rule concerns the hospital’s services, not every separate physician bill.
The hospital may use either of two pricing limits:
- No more than 125% of “amounts generally billed”—a federal term for amounts generally billed for emergency or other medically necessary care to people with insurance covering that care, calculated under federal rules.
- No more than 150% of the hospital’s lowest contracted rate for that service, excluding Medicaid, CHIP and Medicare rates from this second benchmark.
These are alternative ceilings, not a promise of the lower of the two prices, and “25% greater” is not a 25% discount. The federal benchmark is not simply the hospital’s sticker price; its calculation rules permit specified insurance-claims or Medicare/Medicaid-based methods. The public-program exclusions in the second alternative should not be confused with the federal calculation rules for the first. Final law, Section 1; federal definition and calculation rules.
The law expressly preserves charity care for which the patient otherwise qualifies or is entitled. It does not itself establish a new insurance benefit, installment-payment program or universal free-care entitlement. Its pricing permission applies notwithstanding the cited Texas prohibition on certain insurance-based price differences. Final law; Insurance Code 552.003.
HB1612 took effect September 1, 2025. Official history.
What changed along the way?
The original bill proposed a single ceiling of 125% of the lowest eligible contracted rate. The House committee substitute changed that to the two alternatives enacted: 125% of amounts generally billed or 150% of the lowest eligible contracted rate. The original single-ceiling proposal is not the final rule. Introduced version; committee substitute.
Both indexed floor amendments were adopted April 30 and retained in the final law:
- Frank and Howard: corrected “change” to “charge” and explicitly preserved otherwise available charity care. Amendment 1.
- Collier: required the bill or final accounting to notify patients about the direct-payment request option. Amendment 2.
The House-passed, Senate committee and enrolled versions have the same operative text. No Senate floor amendment or conference rewrite appears in the official record. Amendment index; version index.
For the full amendment record, open the official amendment index.
Official bill versions
Compare the published text versions in the official text index. A change is not attributed to a specific amendment here without a verified record.
Who could benefit—and who could bear the costs?
Eligible uninsured patients may pay less than an unrestricted hospital bill and must receive notice of the option. Actual savings depend on the hospital’s benchmarks, its charges and any charity care already available. Hospitals must accommodate qualifying requests and notices; the law may reduce collections on affected bills. It does not quantify either patient savings or hospital revenue changes.
The May 12, 2025 fiscal note anticipates no significant state fiscal impact, assumes costs can be absorbed with existing resources, and anticipates no local-government fiscal impact. It gives no dollar figure or quantified two-year or five-year projection. Those government-budget findings are not an estimate of every patient’s savings or every hospital’s costs.
Review boundary: Both enacted sections, all five versions, both amendments and dispositions, history and all three fiscal notes were checked. The incorporated federal definition and calculation rules were checked in the official 2025 Code of Federal Regulations. This is not a calculation of an individual hospital’s price or a finding that a particular patient qualifies.
Official sources
- Bill history and latest recorded action
- Bill versions, analyses and fiscal notes
- Action history and votes
- Amendment index
Catalog report retrieved 2026-10-25. Check the official record for corrections or later changes.
