Healthcare highlights from Texas’s recently passed $321.3 billion biennium budget


Boram Kim


During its regular session this year, the Texas Legislature passed a $321.3 billion ($144 billion in general funds) state budget for the 2024-2025 biennium, more than a third or $102 billion of which would be devoted to health and human services. 


Stay one step ahead. Join our email list for the latest news.



The Health and Human Services Commission (HHSC) and the Departments of Family and Protective Services (DFPS) and State Health Services (DSHS) receive $93 billion ($37 billion in general funds), $5 billion ($3.2 billion in general funds), and $2.2 billion ($323.4 million in general funds), respectively. 

Combined Medicaid and Children’s Health Insurance Program funding stands at $78.6 billion, with an additional $3.6 billion going to health-related services, which include support for community mental health ($1.4 billion), substance abuse ($554 million), women’s health ($447 million), and early childhood intervention ($396 million). 

In an interview with State of Reform, Rep. Donna Howard (D – Austin), a member of the House Appropriations Committee, spoke to the headway made in healthcare spending.  

“We significantly increased our Texas women’s health program and family planning program,” Howard said. “We got more money in for February Qualified Health Centers to address the needs of our uninsured and underinsured, mobile health clinics—all kinds of things that maybe we would have gotten anyway.

But we used the leverage and the pressure of trying to basically shame the legislators into [supporting moms and their babies]—let’s make sure we’re taking care of them, that they’re healthy, that they get what they need. So that was a positive thing that came out of session.”

Howard said among the wins was the approval of a state plan amendment that would extend Medicaid postpartum coverage to 12 months.

In the previous session, the legislature passed a measure to extend postpartum coverage from two to six months, but HHSC’s waiver application on that extension remains under review by CMS

Reports indicated that the application’s language around coverage for miscarriages may be the reason for the approval delay.  

Lawmakers had a $32.7 billion budget surplus this cycle to work with at the start of the 2023 session when Abbott designated mental health, the fentanyl crisis, and school safety as ‘emergency items’ for the budget. 

The new budget outlines $17.6 billion in property tax relief, $12.3 billion of which is new spending. 

The state will invest $3 billion in behavioral health services over the next two years, including plans in the current budget cycle to build or renovate state mental health hospitals. The community of Uvalde will receive $33 million to build a new behavioral health center that will provide mental health services in the region.

The budget allocates $18 million over the next biennium for opioid overdose prevention measures, including education and overdose reversal medication for first responders and educators who interact with high-risk individuals. Meanwhile, legislation to provide equipment and test strips that detect the presence of fentanyl and derivative substances failed to advance. 

Lawmakers passed a measure requiring the presence of an armed security guard at public schools. HB 3 would provide the Texas Education Agency with $1.1 billion to administer grants to school districts—$15,000 per campus and $10 per student— that would fund armed guards at every school and support mental health first-aid training for school district employees. 

Abbott has yet to sign the school safety measure and has indicated that he will extend the ongoing special session indefinitely until lawmakers institute state-funded vouchers for private schools, stricter penalties for human smugglers, and property tax relief.

At the conclusion of the special session, Abbott will have 20 days to review and either pass or veto items that did not reach him prior to the regular session’s adjournment.