Texas Democrats spent three decades trying to regain control of the governor’s mansion and other top state leadership positions. This Election Day, they pulled off a decisive upset, taking statewide offices and the state House, The victories were fueled in part by widespread voter anger over high healthcare costs and the difficulty of accessing care in the state.
Now the state’s newly elected leaders have two months before the next legislative session to figure out how to deliver on their promises on healthcare affordability and other thorny issues, such as abortion. They face the urgent task of delivering on their healthcare affordability promises while working through a highly partisan, 140-day session. Democratic Gov.-elect Gina Hinojosa and Lt. Gov.-elect Vikki Goodwin, both former state lawmakers, are scheduled to be sworn in on Jan. 19.
A Narrow Window for Change
Hinojosa will become the first Democrat to occupy the governor’s mansion since Ann Richards moved out in 1995. She defeated incumbent Gov. Greg Abbott, a popular and well-funded Republican who had never lost an election before.
The stakes for healthcare are immense. Texas has the highest number of uninsured residents in the country, with about 5 million of its 32 million people lacking coverage, including 1 million children. The state also has one of the nation’s highest maternal mortality rates.
While campaigning, Hinojosa and Goodwin said their top health priorities were expanding coverage, bringing down healthcare costs, and improving women’s health. As state lawmakers, they had previously filed bills aimed at expanding Medicaid and restoring abortion rights, though few of those measures advanced.
A Republican Roadblock
The new Democratic leadership will face strong opposition from the Republican-controlled state Senate. Republican state Sen. Charles Schwertner, who chairs the Senate Business and Commerce Committee, pledged his caucus would hold the line against significant policy changes.
Historically, lieutenant governor has been one of the most powerful elected state posts, with single-handed authority to appoint committees and committee chairs and decide which bills get a floor vote. As lieutenant governor, Patrick used a Republican majority to expand his authority, lowering the state Senate debate threshold to allow partisan bills to pass without Democratic support. But political observers speculate that Senate Republicans may try to pass procedural rules to significantly weaken the lieutenant governor’s power to steer the chamber for when Goodwin takes office.
Dorcaus Robinson, a Houston resident with multiple sclerosis, is one of them. Her monthly health insurance premium has risen to $730. She voted for Hinojosa but is uncertain whether changes will come quickly enough to help her.
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“It’s like football: The next man is up,” Robinson said. “Let’s go in and get this done. I hope they have their plan and they are ready.”
On the federal level, Congress didn’t renew enhanced subsidies for Affordable Care Act premiums last year, passed a budget bill with new restrictions on food and healthcare assistance, and cut the federal health budget. Because of rising costs and enrollment glitches, hundreds of thousands of Texans recently lost health coverage, said Lynn Cowles, director of health and food justice at the policy group Every Texan.
A Bipartisan Path Forward?
Despite the narrow path to victory for major Democratic priorities, there may be room for bipartisan collaboration on certain healthcare issues. Miller suggested that Democrats will likely need to seek measures that can garner wide support, such as boosting healthcare price transparency, tackling healthcare monopolies, and figuring out how to draw down more federal healthcare dollars without tapping the state budget.
A bipartisan state House committee on healthcare affordability, which has been meeting throughout the year, is set to deliver its recommendations before the start of the session. This could provide a potential starting point for finding common ground on at least some healthcare initiatives.
For newly elected Attorney General Nathan Johnson, a key early decision involves the state’s abortion laws. Johnson stated that even if those laws do not change, he will not use the power of his office to sue out-of-state doctors who send abortion medication to the state.
With the legislative session providing a brief window for action, the pressure on the new leadership is immense. The state’s legislative schedule does not call for another regular session until 2029, following the 2028 presidential election when the entire state House will be up for reelection. The actions taken—or not taken—in the coming months will have lasting consequences for the state.
Challenges and Expectations
Political watchers and lobbyists in Austin say it’s too early to tell how the new Democratic leaders will shape legislation, appoint agency leadership, or maneuver around Republican opposition in the state Senate. This may be their best shot to figure things out, as the next regular legislative session isn’t scheduled until 2029.