Texas Talks

In Part 2 of our special Texas Talks series recorded live at the Texas Hospital Association Annual Conference in Fort Worth, host Brad Swail sits down with Chris Bryan, Vice President of Clarity Child Guidance Center in San Antonio, to examine the state of children’s mental healthcare in Texas.
Bryan shares the personal experience that led her from a career in technology to becoming an advocate for children’s mental health and explains how technology and social media have changed the environment in which children grow up.
The conversation explores gaps in the mental health system, including the lack of a consistent continuum of care, difficulties sharing health information, insurance and reimbursement challenges, workforce shortages and the difference between having mental health coverage and actually being able to access treatment.
Bryan also reflects on nearly two decades of advocacy at the Texas Capitol, how the conversation surrounding children’s mental health has changed and what she hopes lawmakers will address during the 90th Texas Legislature.
This is Part 2 of our two-part Texas Hospital Association special. Be sure to watch Part 1 with Allen Harrison on the economics and financial pressures facing Texas hospitals.
00:00 — Introducing Chris Bryan
01:56 — A Personal Journey Into Mental Health Advocacy
04:20 — Technology Meets Healthcare
06:05 — Behavioral Health vs. Mental Health
07:13 — How Technology Is Changing Childhood
10:21 — Gaps in the Mental Health System
11:47 — The Missing Continuum of Care
12:40 — Health Data & Funding Challenges
15:26 — Why Mental Health Coverage Falls Short
17:53 — Coverage Doesn't Mean Access
20:13 — 20 Years of Mental Health Advocacy
22:14 — How the Texas Conversation Has Changed
23:42 — Priorities for the 90th Legislature
24:22 — Closing

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In Part 1 of a special two-part Texas Talks series recorded live at the Texas Hospital Association Annual Conference in Fort Worth, host Brad Swail sits down with Allen Harrison, President of Medical City Healthcare, HCA Healthcare’s North Texas Division, and Chair-Elect of the Texas Hospital Association Board of Trustees.
Harrison shares the personal story that led him to a career in healthcare before turning to the financial pressures facing Texas hospitals and the growing debate over healthcare affordability.
The conversation examines Medicare and Medicaid reimbursement, uninsured patients, the role of commercial insurance, hospital pricing and the growing financial burden placed directly on patients. Harrison also discusses what Texas hospitals are watching ahead of the 90th Texas Legislature and why protecting existing Medicaid funding is a major priority.
Brad and Harrison also explore Texas’ healthcare workforce, including improvements in the nursing shortage, continued demand for specialized healthcare workers and how the patient experience can be complicated by an increasingly difficult-to-understand billing system.
This is Part 1 of our two-part Texas Hospital Association special. Part 2 continues tomorrow with another conversation from the THA Annual Conference.
00:00 — Introducing Allen Harrison
01:47 — A Personal Connection to Healthcare
04:11 — How Healthcare Has Changed
06:29 — Preparing to Lead the Texas Hospital Association
07:45 — Healthcare Affordability & the 90th Legislature
09:22 — Medicare, Medicaid & Hospital Finances
12:09 — Protecting Texas Medicaid Funding
13:25 — What Really Drives Healthcare Costs?
14:53 — How Hospital Pricing Actually Works
16:25 — Managing Financial Uncertainty
18:00 — Insurance & Rising Patient Costs
20:52 — Texas' Healthcare Workforce
23:00 — Shortages in Specialized Healthcare Jobs
24:22 — What Patients Want From Healthcare
26:22 — Closing

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Women are paying $350 for a testosterone pellet. The same hormone, in a men’s tube, can last a year for $86.
Texas Rep. Katrina Pierson (HD 33) — former Trump national spokesperson and chair of the House Subcommittee on Maternal Health, Menopause and Access to Evidence-Based Medicine — sits down with Brad Swail on Texas Talks to walk through her Texas Women’s Health Initiative: baseline hormone testing, HRT coverage, physician liability, iron and prenatal access, and why she says doctors now practice insurance instead of medicine.
Pierson spent 14 years in healthcare, including OB-GYN. She filed a menopause-coverage bill in 2025 that never got a hearing. After the FDA lifted the HRT black-box warning, she took a larger package to the Speaker and got interim charges. In this conversation she explains:
• Why she wants insurance to cover physician-prescribed perimenopause and menopause treatment — including testosterone when medically necessary

• The case for baseline hormone testing before women get labeled with depression or anxiety

• Prior authorization, compounding clinics, and telehealth HRT after the black box came off

• Why Medicaid still requires a prescription for prenatal vitamins, and why she wants physicians able to dispense iron and basics in the office

• What she heard in her subcommittee’s first hearing on prenatal nutrition and Healthy Texas Women

• The gap she flagged in HTW: enrollment is up, participation is down

• The next hearing (date TBD) on menopause and perimenopause, including patient testimony at the Capitol
Texas Talks — policy conversations with the people shaping Texas.
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Chapters

0:00 If a doctor prescribes it, why can’t you get it?

0:55 Intro: Rep. Katrina Pierson

2:26 How the Women’s Health Initiative started

4:28 Baseline hormone testing

7:37 Physician liability and testosterone

8:51 The $350 pellet vs. the $86 men’s tube

10:04 Why women use testosterone

11:25 Telehealth HRT and prior authorization

13:34 Iron, folic acid, and standing orders

24:19 The black-box studies and starting HRT early

27:33 Yesterday’s subcommittee hearing

28:28 Physician dispense and rural access

31:32 What Healthy Texas Women actually is

33:04 Enrollment up, services down

35:59 How is women’s health in Texas right now?

37:22 North Texas Maternal Health Accelerator

38:42 Close
#TexasTalks #KatrinaPierson #WomensHealth #HRT #Menopause #TexasLegislature #txlege

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Why is it so difficult to know what healthcare will cost before you receive it?
On this episode of Texas Talks, host Brad Swail sits down with Patrick Quigley, CEO and co-founder of Sidecar Health, following his testimony before the Texas House Select Committee on Health Care Affordability.
Quigley explains Sidecar Health’s approach to insurance and why he believes greater price and quality transparency, fewer restrictions on where patients receive care, and stronger financial incentives for consumers could help lower healthcare costs.
The conversation explores provider networks, prior authorization, prescription drug prices, clinical quality data and the high cost of delayed care. Quigley also explains how Sidecar’s model rewards members for choosing care that costs less than the plan’s benefit amount and discusses the company’s experience with primary care, mental health services and emergency room utilization.
Finally, Quigley discusses Texas’ healthcare affordability debate and what he would like lawmakers to consider as the state approaches the 90th Texas Legislature.
00:00 — Introducing Patrick Quigley
01:05 — Sidecar Health & the Healthcare Affordability Problem
04:34 — Testifying Before Texas Lawmakers
06:15 — What's Wrong With Provider Networks?
07:43 — Why Patients Don't Know What Healthcare Costs
10:14 — Measuring the Quality of Medical Care
15:58 — Networks, Insurance Companies & Patient Choice
17:20 — How Much Should Healthcare Cost?
20:10 — The Texas Healthcare Opportunity
22:12 — Prior Authorization & Trusting Doctors
23:37 — Access to Care & Emergency Room Costs
26:33 — Prescription Prices & Consumer Incentives
29:26 — Why Healthcare Prices Vary by Location
32:11 — What Should Texas Lawmakers Do?
35:00 — Closing Thoughts

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What is driving rising litigation and insurance costs in Texas—and what does Texans for Lawsuit Reform want lawmakers to do about it?
On this episode of Texas Talks, host Brad Swail sits down with Ryan Patrick, the new CEO of Texans for Lawsuit Reform, to discuss his vision for the organization and its priorities heading into the 90th Texas Legislature.
Patrick draws on his career as a prosecutor, judge, U.S. Attorney and private-practice attorney to explain why he believes Texas needs to refocus on civil justice and tort reform. He discusses the impact of large verdicts and litigation on insurance premiums, businesses and consumers, as well as TLR’s concerns about medical damages, litigation surrounding commercial vehicles, and the incentives created by the current system.
The conversation also looks ahead to the next legislative session, where Patrick says TLR will pursue reforms addressing medical damages, staged accidents, insurance fraud, liability involving criminal activity, and other areas of Texas civil law.
Patrick also explains how he hopes to lead a new generation at TLR while building on the organization’s three decades of work in Texas.
00:00 — Introducing Ryan Patrick
00:50 — From Prosecutor to Judge to U.S. Attorney
03:18 — Why Patrick Joined Texans for Lawsuit Reform
04:59 — A New Generation at TLR
07:06 — Refocusing on Tort & Civil Justice Reform
09:28 — Texas Courts & the Case for Reform
13:48 — Venue Shopping & Consistency in the Courts
16:40 — Litigation, Insurance Premiums & Rising Costs
19:26 — How Lawsuits Can Impact Small Businesses
23:03 — Medical Damages & TLR’s Next Reform Push
28:32 — Do Large Verdicts Make Texans Safer?
30:34 — When Insurance Becomes Unaffordable
33:04 — How Texas Compares with Other States
40:41 — Staged Accidents & Insurance Fraud
41:36 — Priorities for the 90th Legislature
47:21 — TLR’s Strategy for the Next Session
48:10 — Final Thoughts

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