1. United States
2. Texas
3. Letter

I strongly oppose HB 44, which prohibits Medicaid and CHIP providers from refusing to treat patients based solely on their immunization status. While the bill claims to promote patient access, it dangerously undermines public health and medical standards, particularly for the most vulnerable populations. Reasons for opposition: 1. It endangers medically fragile patients. This bill forces providers to accept unvaccinated patients, regardless of the risk to others in their care. Clinics that serve immunocompromised children, elderly patients, and those with chronic illnesses may be unable to protect their patients from vaccine-preventable diseases without turning away individuals who pose a health risk. 2. It overrides medical expertise and clinical judgment. Doctors and clinics must be trusted to make science-based decisions about their patient populations and infection control policies. This bill politicizes medical care and prioritizes non-medical personal beliefs over the safety of the entire patient community. 3. It opens the door to abuse of exemptions. HB 44 requires providers to honor oral or written exemption requests for “reasons of conscience,” a vague and easily exploitable loophole. This effectively eliminates any enforceable vaccination policy in clinics that serve Medicaid and CHIP populations, who are already at higher risk of poor health outcomes. 4. It creates a double standard for public health. Providers serving Medicaid and CHIP recipients would be forced to operate under different standards than private providers, which further stigmatizes and jeopardizes care for low-income Texans. Public health policies should be consistent, equitable, and rooted in science — not dictated by politics. 5. It ties provider reimbursement to a non-medical mandate. Threatening reimbursement to providers who prioritize vaccination is punitive and short-sighted. It disincentivizes evidence-based practices and puts bureaucratic compliance over patient safety and clinical autonomy. ⸻ Bottom line: HB 44 weakens public health protections, undermines provider autonomy, and exposes vulnerable patients to avoidable harm. We must empower healthcare providers — not politicians — to determine how best to serve their patients safely and responsibly. I urge legislators to repeal or oppose HB 44 in its current form.