Texas HB 18 'Rural Health Stabilization Act' Signed, New Rural-Hospital Finance Office + Medicaid Rate Work

Gov. Abbott signed HB 18 on June 20, 2025 (effective immediately), creating a State Office of Rural Hospital Finance, directing HHSC to improve rural Medicaid reimbursement (rate enhancements, payment-methodology revisions, reduced regulatory burden), and adding a Medicaid add-on for rural hospitals with OB/GYN services. Many Texas FQHCs operate in rural counties coupled to a local rural hospital, so the rural safety-net and Medicaid rate environment shape referral patterns, OB access, and community financial stability around those FQHCs.