GUEST COMMENTARY
Rural healthcare in Texas is at its breaking point. Since 2010, 20 rural hospitals have closed their doors, and dozens more remain at risk of closure.
In Texas, 202 of our 254 counties are classified as rural, and more than 34 counties have no physician at all.
These aren’t just numbers on a report — they represent mothers going without prenatal care, seniors waiting months for a diagnosis, and hardworking Texans traveling hours for basic checkups.
As Health and Human Services Secretary Robert F. Kennedy Jr. said while visiting Texas last month, “Rural America is in crisis.” He was here to meet with Gov. Greg Abbott and healthcare leaders discussing the $50 billion Rural Health Transformation Program, created under the One Big Beautiful Bill Act (OBBA).
This five-year initiative is designed to stabilize rural hospitals by investing in infrastructure and care delivery. Half of the program’s funds will be allocated directly to states, while the remaining funds will be awarded through a competitive application process.
The question is: will Texas seize this opportunity, or will we risk losing even more Texans in rural communities?
The health challenges facing our state are already devastating. A statewide survey by the Episcopal Health Foundation found that two-thirds of Texans view type-2 diabetes as a significant problem, and nearly half of households are affected by it.
Almost half of our counties are maternity care deserts, with 22 percent of Texas women receiving late or inadequate prenatal care. And Texas ranks 50th in mental healthcare access.
Rural Texans are older, sicker, more uninsured and live farther from care than urban Texans. Every day of delay means another life lost, or conditions worsen due to the gaps in access to adequate care.
That is why the Texas Nurse Practitioners (TNP), which represents more than 47,000 nurse practitioners statewide, has submitted a proposal to the Texas Health and Human Services Commission under the OBBA Rural Health Transformation Program.
Our proposal focuses on delivering care immediately by building on what we already know works. The proposal calls for expanding nurse practitioner-led access models through rural clinics, mobile units and integrated behavioral health care, ensuring we meet patients where they are.
It invests in the nurse practitioner workforce by creating rural training sites, fellowships and loan repayment programs to keep providers in the communities that need them most. It expands telehealth infrastructure so that broadband, secure platforms and remote monitoring can bring care to even the most remote Texans.
We’re also calling on the state to modernize outdated practice laws which force nurse practitioners into unnecessary physician delegation agreements and restrictions that limit access without improving safety or outcomes.
We know these models save lives. In one study, rural patients with chronic conditions saw a 60 percent reduction in hospitalizations within 12 months when cared for by nurse practitioners. Today, 48 percent of Texas counties already have more primary care nurse practitioners than physicians.
In rural communities, nurse practitioners outnumber physicians in nearly a third of all rural counties. They are the providers who show up, stay put and keep our communities healthy.
Nurse practitioners are highly educated and qualified; they’re graduate-level clinicians, nationally certified and trained to diagnose, prescribe and manage both chronic and preventive care.
In countless rural communities across Texas, they are the only healthcare provider within miles; yet outdated policies and underfunding hinder their full ability to treat patients.
With proper support, nurse practitioners can continue to be the backbone of a resilient rural health system.
Texas has the opportunity to secure federal funding to stabilize and transform rural healthcare. But time is short, and the stakes are high. We must prioritize solutions that deliver care now, not years from now, to ensure Texans no longer face unnecessary barriers to quality healthcare.
With nurse practitioners leading the way, every community across rural Texas can finally gain access to the preventive and timely care they deserve.
Texas Nurse Practitioners is the largest state association of nurse practitioners in the country. TNP advances and supports the role of NPs who provide accessible, quality healthcare across Texas each and every day. To learn more, visit: www. texasnp.org.
Comment
Comments