An affordable prescription can be the difference between life and death. But whether Texans have access to crucial medications isn’t determined by their doctors and health insurance plans alone. Access starts in the halls of Congress and on the Senate floor.
This November, Texans won’t find a single question about healthcare on their ballots. Instead, they’ll elect the state and federal officials with power over the laws, programs, and regulations determining that care.
Here’s what that could mean for three groups of Texans who rely on those policies to live.
Diabetic Texans
The United States has faced an insulin crisis over the last decade, with extremely high medication prices resulting in inconsistent care for diabetics.
High costs, ranging from $100 to $1,000 for a 30-day supply, encourage the rationing of insulin—a move that can create further illness and lead to death.
Prices of insulin in the US are also 5 to 10 times higher than in other countries because the domestic market is controlled by three major drug companies, which have the power to leverage higher prices with little accountability. Between 2007 and 2018, insulin’s price in the US increased by 262%, with slight relief in 2023.
Texas, in particular, has taken steps to lower insulin costs. In 2021, Texas lawmakers passed Bill 827, which capped what patients enrolled in state-regulated health plans are required to pay for insulin, solidifying prescriptions at $25 for a 30-day supply.
But after Trump’s Big Beautiful Bill Act led to increased healthcare premiums in 2025, many Texans dropped their insurance coverage because they couldn’t afford it. The result has been uninsured diabetics once again facing exorbitant insulin prices.
These costs could change as Texans elect representatives who will have direct control over drug costs. The Texas Senate can pass legislation to preserve the existing $25 cap, change which health plans it covers, or expand affordability.
One of the candidates set on expanding the affordability of prescription drugs, like insulin, is Democratic US Senate candidate James Talarico, a diabetic himself, who was a major force behind the passing of the bill to cap insulin prices. Talarico wants to address the root of the problem by reversing Republican cuts on Medicaid and Medicare so that more people are able to afford health insurance covered within the insulin cap program.
Child-bearing Texans
November’s election could also shape what reproductive healthcare Texans can access and under what circumstances. In 2021, Texas passed Senate Bill 8, known as the Texas Heartbeat Act, which is the most restrictive abortion ban in the US.
After the bill went into effect, both infant and maternal deaths spiked across the state. In 2022, the Texas Legislature put House Bill 1280 into effect, which ensured that medical providers who assisted in abortions would face felony charges, loss of medical licenses, and increased prison time.
These bans outlaw more than just abortion, they limit what medications Texans can access to treat other medical or reproductive issues.
Some of the medications at stake are drugs like mifepristone, misoprostol, and methotrexate—medicines not only used to terminate pregnancies, but to manage miscarriages and treat stomach ulcers.
Texas lawmakers recently moved to further restrict how these abortion-inducing medications can be distributed in the state, making access to life-saving care more difficult.
In June, an Austin-area woman filed a federal complaint after almost dying during a miscarriage, accusing two emergency rooms of denying her timely medication and treatment.
Other consequences of these laws and barriers are the preventable deaths of pregnant Texans, particularly Black women, who are disproportionately more likely to be denied life-saving care.
In 2024, San Antonio resident Tierra Walker repeatedly asked for an abortion after being diagnosed with a pregnancy-related high blood pressure condition, but the doctor decided that delivering the baby would be the best treatment. Because of that decision, Walker didn’t make it. Her family is now suing doctors and state officials in the first lawsuit over a death linked to an abortion ban. Among the officials being sued is Attorney General Ken Paxton, the Republican candidate running against Talarico for US Senate. Paxton has fervently supported anti-abortion legislation in Texas since 2003, making the criminalization of abortion a priority while serving as Texas AG.
State law specifically addresses the narrow window given to doctors to provide abortions during dangerous pregnancies, what constitutes a medical emergency, and what medications associated with abortion can be legally used when. Future legislatures have the power to change or enforce these laws.
Texans are choosing between candidates like James Talarico and Ken Paxton, who will have a role in what happens next, like whether the state’s existing restrictions stay in place, whether medical care is expanded or further banned, and whether lawmakers pursue new regulations involving abortion medication.
HIV-positive Texans
Texas has the highest rate of HIV in the country, with Dallas and Houston seeing the most cases.
Black and Hispanic Texans make up a disproportionate number of HIV positive cases because of unequal access to healthcare, housing instability, poverty, and discrimination within the healthcare system.
One program working to address these problems is the Texas HIV Medication Program (THMP), which has served more than 24,000 low-income and uninsured Texans living with HIV. This program has provided life-saving drugs, like Aptivus and Atripla at low or no cost for nearly 40 years.
But access to this program is in jeopardy as the election approaches. The Texas Department of State Health Services (DSHS) says the HIV program is running out of money at a time when high healthcare costs are affecting millions of Texans already. DSHS is asking the Legislature for more than $69 million to keep THMP afloat. While there has historically been bipartisan support for ending the global HIV crisis, more recent spending bills from House Republicans have sought to slash the funding given to domestic HIV Programs.
Texans aren’t voting directly on the HIV Medication Program in November, but are choosing the lawmakers who will make decisions about state spending, including if Texas meets the program’s funding needs.
One of those lawmakers is Democrat US House Rep. Henry Cuellar (D-28), who is up for reelection in November. Earlier this month, Cuellar brought more than $310,000 to Laredo in a federal grant to support HIV care for South Texas.
For people who rely on the program, who Texas elects isn’t abstract. HIV treatment—like insulin treatments for diabetics— requires consistent access to medication, meaning a funding gap could impact whether Texans can get the prescriptions at all.
While the ballot may not explicitly name these different medications, the candidates Texans vote in will have the final say on whether or not the public has access to the care they need.
