🟡Relating to the authority of certain medical consenters to assume financial responsibility for certain out-of-network medical care provided to children in foster care.

🟡 SB 855: Out-of-Network Medical Care for Foster Children

What it says it does:
SB 855 allows foster parents or other authorized medical consenters to take a child in foster care to an out-of-network doctor if they agree to pay for it themselves. It also lets them enroll the child in another health insurance plan of their choosing. DFPS and Medicaid managed care plans are not required to cover these costs unless a court orders them to.

What it actually changes:
It creates a legal path for private payment and new coverage options outside STAR Health, the state’s foster care health plan. It protects managed care companies from having to pay for out-of-network care while stopping them from blocking families who choose to go outside the network.

Who is pushing for it:
Supporters listed in committee materials include Texas Public Policy Foundation, Goldwater Institute, One Accord for Kids, Cicero Action, and Texas CASA. State agencies such as DFPS and HHSC were present to provide information but did not take a position.

Who benefits:
Families who can afford to pay or who have access to nonprofit assistance gain faster access to care. Out-of-network doctors and private insurers gain paying patients. DFPS and managed care organizations avoid new financial obligations while still appearing flexible.

Who gets left out or exposed:
Families without resources cannot use this new option, so children in their care remain limited to the STAR Health network even when care is delayed or unavailable. The bill relies on private payment rather than solving network shortages statewide.

Why this matters long term:
The bill may reduce immediate delays for some foster children but weakens pressure on the state to fix its provider network. Over time, access to care could become uneven, with better outcomes for families who can afford private options and persistent delays for those who cannot.

What to watch next:
HHSC and DFPS rulemaking on notification forms, reporting, and STAR Health contract language. Future audits or reports showing where out-of-network care is being used most often will reveal whether the law is expanding opportunity or deepening inequality.

Bottom line:
SB 855 gives foster families more flexibility, but it leaves major access gaps in place. It helps those who can pay while offering little relief to those who cannot, and it may take attention away from fixing the system itself.

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