PLATFORM

HEALTHCARE REVIVAL : MY WAY

I am the only candidate in the 2026 U.S. Senate primary with hands-on healthcare management experience, having led primary care clinics, wound care & hyperbaric medicine clinics, a hospitalist group, while supporting patients through the peak of COVID with drive-through clinics, telemedicine, and testing operations, including managing patient house calls operations, worked in hospital based and surgical center systems. For the past five plus years, I have been a co-owner of a Texas-based home health and hospice company serving 73 counties in West and North Texas, giving me firsthand insight into the challenges facing rural and urban healthcare alike. I know what works, what is broken, and how federal regulations, insurance practices, and underfunded reimbursement systems hurt patients and providers - and I am running to revive healthcare in Texas, put control back in the hands of patients and providers, and deliver real solutions for affordable, accessible, and high-quality care across our state.

A. REVIVAL OF THE TEXAS RURAL HOSPITALS

Texas Rural Hospitals: Crisis and Need for Action

What's Happened in Texas

• Texas has lost dozens of rural hospitals over the past two decades.

According to recent research, Texas has seen about 25 rural hospital closures in the last 20 years - more than any other state.

Over the last decade, official reports count 14 rural hospital closures in Texas, each leaving communities without emergency care and basic services.

Hospitals at Risk Right Now

Despite the closures already occurring, the crisis isn't over - many more facilities remain vulnerable:

Texas has roughly 156 rural hospitals today.

• 108 have reduced or lost critical services.
• 87 are at risk of closure if conditions don't improve.
• 22 are at immediate risk of shutting down soon.

This means more than half of rural hospitals in Texas are facing financial stress that could lead to closure without targeted intervention.

Why This Matters

Rural hospitals are not just buildings - they are lifelines for people and communities:

• They provide emergency services, often the only option within driving distance.
• They offer maternity care, chronic disease management, and preventive medicine.
• When a rural hospital shuts down, mortality rates rise up to 8.7% because residents must travel farther for care.

Communities lose jobs, economic anchors, and local clinics when hospitals close - all at a time when rural Texans already face physician shortages and higher uninsured rates.

& My Plan for Healthcare Revival

If elected U.S. Senator from Texas, I will champion a comprehensive Healthcare Revival Agenda focused on revitalizing rural healthcare systems so every Texan can get care close to home.

1) Stabilize and Protect Rural Hospitals

• Expand federal funding streams to prevent closures and help hospitals stay open.
• Increase Medicare and Medicaid reimbursement rates so rural facilities can operate sustainably.

2) Invest in Workforce and Training

• Incentivize doctors, nurses, and specialists to practice in rural Texas through loan repayment and tax credits.
• Expand support for local healthcare education programs.

3) Telehealth and Infrastructure Upgrades

• Invest in broadband and telehealth technology so rural patients can access specialist care remotely.
• Provide grants for modern equipment and facility upgrades.

4) Targeted Public Health Programs

• Expand preventive care outreach in rural communities - particularly for maternal health, chronic disease management, and elder care.

Why This Matters for Texas

Rural Texans - veterans, farmers, families - deserve access to quality healthcare without hours of travel. Strengthening rural hospitals means protecting lives, supporting local economies, and building a healthier future for every community.

B. Fixing the Private Insurance & Medicare Advantage Reimbursement Crisis

The Core Problem

Across Texas, healthcare providers are facing a serious and growing crisis - Medicare Advantage (MA) plans and private insurance companies are paying far less than the true cost of care, even as operational and staffing expenses have nearly doubled over the last several years.

While healthcare costs rise due to:

• workforce shortages,
• higher wages,
• inflation,
• supply chain disruptions,
• regulatory compliance, and
• technology and infrastructure needs,

reimbursement rates from Medicare Advantage plans and private insurers have failed to keep pace - creating an unsustainable financial gap for providers and facilities.

This gap is now one of the leading threats to patient access, provider sustainability, and rural healthcare survival in Texas.

How Low Reimbursement Impacts the Entire Care Continuum

Primary Care Physicians & Providers

• Medicare Advantage and private insurers often reimburse significantly less per visit than the actual cost of providing care.
• Administrative burdens, delayed payments, and high denial rates further reduce effective reimbursement.
• Result: fewer physicians accepting MA plans, shorter appointment times, or practice closures - especially in rural and underserved areas.

Specialty Care Visits

• Specialists face underpayment for complex, time-intensive services.
• Prior authorization delays and post-service denials add financial risk.
• Result: longer wait times for specialty care and reduced access for seniors and chronically ill patients.

Hospital Care

• Hospitals report that Medicare Advantage plans routinely pay below traditional Medicare rates, despite higher administrative requirements.
• Private insurers often negotiate rates that do not reflect staffing, emergency readiness, or uncompensated care burdens.
• Result: service cuts, hospital consolidation, and rural hospital closures.

Home Health Care

• Home-based providers experience some of the lowest margins in healthcare, with MA plans frequently paying below the cost of care delivery.
• Rising labor, fuel, and compliance costs have made home care financially fragile.
• Result: fewer providers serving high-need seniors and disabled Texans.

Nursing Care & Long-Term Care Facilities

• Medicare Advantage and private insurance reimbursements do not adequately cover staffing ratios, wage competition, or regulatory requirements.
• Facilities struggle to recruit and retain nurses and aides.
• Result: reduced capacity, staff burnout, and declining quality of care.

Rehabilitation & LTAC (Long-Term Acute Care) Facilities

• These facilities provide high-acuity, post-hospital care but face payment structures that undervalue complex recovery services.
• MA plans often limit lengths of stay or deny coverage altogether.
• Result: premature discharges, care disruptions, and worse patient outcomes.

The Reality: Costs Are Rising Faster Than Payments

Today, many Texas healthcare providers face a stark reality:

• Operational and staffing costs have risen 30-50% or more, depending on the sector.
• In some cases, costs have nearly doubled, especially for labor-intensive services.
• Meanwhile, Medicare Advantage and private insurance reimbursement increases have remained flat or minimal - or declined after accounting for inflation and administrative barriers.

This mismatch is pushing providers to the brink and limiting access for patients who already have insurance.

My Plan as Texas's Next U.S. Senator

If elected, I will make fair reimbursement from Medicare Advantage plans and private insurers a top federal priority, because insurance coverage is meaningless if providers can't afford to deliver care.

1. Enforce Payment Fairness and Transparency

I will push for federal standards that:

• Require MA plans and private insurers to justify reimbursement rates based on actual cost data;
• Increase transparency around negotiated rates and denial practices;
• Prevent "take-it-or-leave-it" contracting that disadvantages rural and independent providers.

2. Medicare Advantage Accountability Reform

I will advocate for:

• Payment parity between Medicare Advantage and traditional Medicare for the same services;
• Stronger federal oversight of claim denials, delays, and down-coding;
• Penalties for plans that consistently underpay or delay provider reimbursement.

3. Protect Provider Networks and Patient Access

Low reimbursement forces providers to exit insurance networks. I will work to:

• Prevent MA plans and private insurers from offering "phantom networks" with inadequate provider access;
• Ensure Texans can actually see doctors and receive care under their insurance plans.

4. Strengthen Negotiating Power for Providers

I will support policies that:

• Allow independent physicians, rural hospitals, nursing homes, and home-based providers to negotiate collectively with large insurance companies;
• Level the playing field between community providers and multibillion-dollar insurance corporations.

5. Tie Reimbursement to Workforce Sustainability

Healthcare reimbursement must reflect real-world staffing needs. I will push for:

• Payment models that account for workforce shortages and competitive wages;
• Incentives for insurers to support long-term workforce stability instead of short-term cost cutting.

Why This Matters for Texans

This is not a partisan issue - it's a patient access issue.

When insurance companies underpay:

• Providers close or leave networks;
• Patients lose access to care despite having coverage;
• Rural and underserved communities suffer first.

As Texas's next U.S. Senator, I will fight to ensure insurance works for patients and providers - not just insurance companies. Fair reimbursement is essential to reviving healthcare access, strengthening our workforce, and keeping care close to home for every Texan.

C. Ending the Hospice Cap Penalty: Putting Patients Before Bureaucracy

The Problem: A Regulation That Punishes Compassionate Care

Under current federal healthcare regulations, hospice agencies are subject to a Medicare hospice "aggregate cap." This cap limits the total amount a hospice provider may receive per patient over a set period.

When a hospice patient lives longer than the government's projected timeframe, the hospice agency is often required to return previously paid funds to the Centers for Medicare & Medicaid Services (CMS) - even though the care was medically appropriate, lawful, and already delivered.

In plain terms:

• If a hospice patient survives longer than expected,
• The hospice provider is financially penalized,
• And forced to repay money for care that helped keep the patient comfortable, stable, and alive.

This policy creates a perverse and dangerous incentive in our healthcare system.

Why This Regulation Is Wrong

1. It Penalizes Providers for Prolonging Life

Hospice care is meant to:

• Manage pain,
• Improve quality of life,
• Support patients and families through serious illness.

But under the current cap system, providers are effectively punished for doing their job too well - for stabilizing patients, managing symptoms, and preventing unnecessary hospitalizations.

No healthcare system should penalize care that extends comfort, dignity, or life.

2. It Forces Financial Risk onto Hospice Agencies

Hospice agencies:

• Cannot predict exactly how long a patient will live,
• Have no control over disease progression,
• Still must provide full care regardless of time.

Yet CMS requires agencies to repay funds years later, often after audits, creating:

• Severe financial instability,
• Cash flow crises,
• Risk of hospice closures - especially for small, rural, and nonprofit providers.

3. It Discourages Access to Hospice Care

This regulation leads to unintended but harmful consequences:

• Providers may hesitate to admit complex or non-cancer patients who often live longer,
• Patients with dementia, heart failure, or chronic illness may face delayed or denied hospice access,
• Families lose access to supportive end-of-life services they desperately need.

This is rationing by regulation, not by medical judgment.

4. It Undermines the Ethical Foundation of Hospice Care

Hospice care is about:

• Comfort, not clocks;
• Care, not quotas;
• Human dignity, not actuarial formulas.

A policy that ties payment to whether a patient dies "on time" is ethically indefensible.

My Plan to Fix This as a U.S. Senator from Texas

As Texas's next U.S. Senator, I will fight to modernize hospice regulations so they reflect medical reality, ethical care, and patient-centered values.

1. Reform or Eliminate the Hospice Aggregate Cap

I will introduce and support legislation to:

• Remove punitive repayment requirements when care is medically appropriate;
• Adjust or eliminate the aggregate cap so it no longer penalizes longer hospice stays;
• Ensure hospices are paid for care actually delivered - not forced to refund it after the fact.

2. Replace Time-Based Caps with Clinical Accountability

I will push CMS to:

• Base oversight on clinical appropriateness and quality outcomes, not length of stay;
• Use medical review standards instead of arbitrary time thresholds;
• Protect providers who demonstrate proper documentation and ethical care.

3. Protect Hospices from Retroactive Clawbacks

I will advocate for:

• Limits on retroactive CMS repayment demands;
• Predictable payment structures so providers can plan, hire staff, and expand access;
• Safe harbors for nonprofit, rural, and community-based hospice agencies.

4. Expand Access for Non-Cancer and Chronic Illness Patients

Current rules disproportionately affect patients with:

• Dementia,
• Heart failure,
• COPD,
• Neurological and chronic conditions.

I will work to ensure hospice eligibility and payment rules do not discriminate based on diagnosis or unpredictable disease trajectories.

5. Establish a Hospice Payment Reform Task Force

I will push for a bipartisan federal task force including:

• Hospice clinicians,
• Nurses,
• Physicians,
• Patient advocates,
• Rural and nonprofit providers,

to design a fair, sustainable hospice payment model that prioritizes dignity, ethics, and access.

Why This Matters for Texans

No hospice should fear bankruptcy for helping a patient live longer.

No family should worry that care decisions are influenced by financial penalties.

No healthcare system should tie reimbursement to whether someone dies within a government-approved timeframe.

As Texas's next U.S. Senator, I will fight to end regulations that punish compassion, protect hospice providers, and ensure that end-of-life care in America is guided by human dignity - not arbitrary caps.

D. Fixing Hospice and Palliative Care Regulations: Ending Penalties and Closing Dangerous Gaps

A Broken System That Fails Patients Before Hospice Begins !

In addition to the flawed hospice cap rule, there is another serious regulatory failure in our healthcare system:

There is currently no direct Medicare or insurance reimbursement for palliative care when a patient is admitted under a "palliative care" order instead of "hospice care."

This creates a devastating gap in care - especially for small, community-based hospice agencies.

The Palliative Care Reimbursement Gap

What Happens Today

When a physician refers a patient to a hospice agency, the admission order may state:

• "Palliative care" (symptom management, comfort-focused care, not yet end-of-life), rather than
• "Hospice care" (which triggers Medicare hospice benefits).

Under current rules:

• Hospice care is reimbursed
• Palliative care is not

That means:

• There are no standardized diagnosis codes
• No dedicated billing or payment structures
• No sustainable reimbursement pathway for hospice agencies to provide palliative care

The Result: No Incentive, No Access

Because palliative care is not reimbursed:

• Small and mid-sized hospice agencies cannot absorb the cost of staffing, visits, medications, coordination, and compliance with zero payment;
• Providers are forced to decline palliative care admissions - not because they don't want to help, but because they cannot financially survive;
• Patients who are not yet hospice-eligible lose access to comfort-focused care that could improve quality of life and prevent hospitalizations.

This is not a failure of providers - it is a failure of federal healthcare regulation.

Why This Is Dangerous and Unethical

1. Patients Are Left Without Care

Palliative care patients often suffer from:

• Advanced chronic illness,
• Pain, nausea, anxiety, and breathlessness,
• Frequent emergency room visits.

Without palliative care support, patients deteriorate faster and families struggle without guidance.

2. It Forces an Artificial Choice

Current regulations unintentionally push providers and families into an impossible position:

• Either delay care entirely, or
• Transition patients into hospice sooner than clinically appropriate just to access reimbursement.

Healthcare policy should support clinical judgment, not force decisions based on billing rules.

3. It Disproportionately Hurts Small and Rural Providers

Large systems may absorb unreimbursed care. Small hospice agencies cannot.

As a result:

• Independent hospices close,
• Rural communities lose access,
• Patient choice disappears.

My Plan as Texas's Next U.S. Senator

As U.S. Senator, I will work to modernize hospice and palliative care policy so patients receive care when they need it - and providers are paid fairly for delivering it.

1. Establish Federal Reimbursement for Palliative Care

I will introduce and support legislation to:

• Create formal Medicare reimbursement pathways for palliative care;
• Ensure that when a hospice agency admits a patient for palliative care, that care is paid for;
• End the zero-payment scenario that currently blocks access.

2. Create Diagnosis Codes and Billing Codes for Palliative Care

I will work with CMS to:

• Establish clear diagnosis codes for palliative care;
• Implement billing and payment codes that reflect the real cost of interdisciplinary care;
• Allow hospice agencies to bill appropriately for physician oversight, nursing, social work, and care coordination.

3. Allow Hospices to Provide Both Palliative and Hospice Care

I will advocate for regulatory flexibility so:

• Hospice agencies can provide palliative care before hospice eligibility;
• Care can transition smoothly without forcing artificial timelines;
• Patients are supported earlier, reducing hospitalizations and costs.

4. Protect Small and Community-Based Hospice Providers

My reforms will prioritize:

• Independent and nonprofit hospices,
• Rural providers,
• Agencies that serve high-need and complex patients.

No hospice should have to choose between financial survival and patient care.

5. Align Payment With Patient Outcomes, Not Labels

I will push CMS to:

• Focus on symptom control, patient comfort, and care quality;
• Remove rigid distinctions that exist only for billing purposes;
• Support care models that improve quality of life and reduce unnecessary hospital use.

Why This Matters for Texans

Palliative care is not optional - it is essential.

Patients should not be denied comfort care because of paperwork.

Hospice agencies should not be punished for compassion.

And healthcare regulations should never force providers to choose between ethics and economics.

As Texas's next U.S. Senator, I will fight to:

• End penalties that punish good care,
• Close reimbursement gaps that block access,
• And build a healthcare system that honors dignity, compassion, and common sense.

E. Lowering Prescription Drug Costs: Putting Texans Before Big Pharma

The Problem: Texans Are Paying Too Much

Prescription drug prices are out of control - and Texas families, seniors, and rural communities are paying the price.

Too often:

• Drug prices rise year after year with no transparency,
• Middlemen profit while patients suffer,
• Seniors spend thousands just to stay healthy,
• Rural pharmacies struggle to survive.

This isn't a free market - it's a rigged system that protects Big Pharma and pharmacy middlemen instead of patients.

As a Republican, I believe in competition, transparency, and accountability - not corporate games that drain Texans' wallets.

My Commitment as Texas's Next U.S. Senator

I will help turn the current fight against Big Pharma and pharmacy middlemen into law - protecting patients while strengthening market competition.

1. Support Direct Drug Price Negotiations

Texans should not be forced to pay higher prices than other countries or federal programs for the same medications.

I will support policies that:

• Allow direct negotiation of drug prices, especially for high-cost, single-source medications;
• Focus negotiations on drugs with no real market competition;
• Protect innovation while stopping price gouging.

Negotiation is not price control - it is basic consumer leverage.

2. Expand Access to Generics and Biosimilars

Competition lowers prices - period.

I will work to:

• Speed approval of safe, effective generics and biosimilars;
• Prevent brand-name drug companies from abusing the patent system to block competition;
• Encourage true market competition that drives prices down naturally.

More competition means lower costs for families and seniors.

3. Crack Down on PBMs and Their Hidden Fees

Pharmacy Benefit Managers (PBMs) were meant to lower costs - instead, they've become unaccountable middlemen.

I will push to:

• Expose PBM pricing schemes and hidden fees;
• Ban spread pricing that inflates costs for patients and taxpayers;
• Require transparency so patients know where their money is really going.

If PBMs are driving up costs, they should be held accountable - just like anyone else in the marketplace.

4. Incentivize Rural Texas Pharmacies to Lower Prices

Rural pharmacies are lifelines - but many are being squeezed out by unfair reimbursement and PBM practices.

I will fight for:

• Incentives that help rural pharmacies stay open and competitive;
• Fair reimbursement so small pharmacies can offer affordable prices;
• Policies that protect local pharmacies from corporate PBM abuse.

When rural pharmacies close, Texans lose access - and costs go up.

5. Protect Seniors' Social Security Checks

No senior should have to choose between:

• Filling a prescription, or
• Paying for food, rent, or utilities.

I will work to:

• Reduce out-of-pocket drug costs for seniors;
• Ensure Social Security checks go toward living with dignity - not overpriced medications;
• Stop cost-shifting that forces seniors to absorb Big Pharma's excesses.

The Conservative Principle at Stake

This is about:

• Free markets that actually work,
• Standing up to corporate abuse,
• Protecting seniors and families,
• Keeping healthcare affordable without government overreach.

Lower drug prices strengthen families, rural communities, and the Texas economy.

Bottom Line

As a conservative Republican and Texas's next U.S. Senator, I will:

• Fight Big Pharma price gouging,
• Expose PBM corruption,
• Promote competition,
• Protect rural pharmacies,
• And make sure Texans - not corporations - come first.

F. Lowering Health Insurance Premiums: Putting Texans Back in Control

The Problem: Premiums Are Crushing Texas Families

Health insurance premiums continue to rise - and Texas families, farmers, ranchers, seniors, and small businesses are being crushed.

For too many Texans:

• Monthly premiums take a growing share of paychecks,
• Small businesses struggle to offer coverage,
• Rural families have fewer choices and higher costs,
• Seniors are forced to stretch fixed incomes.

This is not sustainable - and it is not what a free-market healthcare system should look like.

Building on Republican Leadership

Texas's Republican leadership has already begun pushing major insurers to bring premiums down and rein in excessive rate hikes.

As Texas's next Republican U.S. Senator, I will continue and expand that mission at the federal level - standing up to insurance monopolies and restoring competition and consumer choice.

My Plan to Lower Health Insurance Premiums

1. Increase Competition So Premiums Drop Naturally

Premiums rise when competition disappears.

I will fight to:

• Break up insurer dominance in regional markets;
• Encourage new insurers to enter the Texas marketplace;
• Remove federal barriers that limit competition across state lines.

More competition means lower prices, better plans, and more choice.

2. Support Association Health Plans for Small Businesses

Small businesses shouldn't pay more simply because they're small.

I will support:

• Association Health Plans (AHPs) that allow small businesses, farmers, ranchers, and trade groups to pool together;
• Market-based solutions that give small employers bargaining power similar to large corporations;
• Affordable coverage options without Washington micromanagement.

3. Roll Back Regulations That Artificially Raise Premiums

Not every federal mandate improves care - but many raise costs.

I will work to:

• Eliminate unnecessary regulations that drive up premiums;
• Give states more flexibility to design insurance markets that work for their populations;
• Reduce compliance costs that insurers pass directly onto families.

Lower regulatory burden means lower premiums.

4. Protect Short-Term, Lower-Cost Insurance Plans

Texans deserve options - not one-size-fits-all plans.

I will defend:

• Short-term and alternative health plans that offer affordable coverage;
• Consumer choice for families between jobs, starting businesses, or transitioning careers;
• The right of Texans to select plans that meet their needs and budgets.

Affordable options should not be banned just because they don't fit Washington's preferences.

5. Prioritize Seniors and Rural Texans

Rural Texans and seniors face higher premiums and fewer choices.

I will focus on:

• Protecting rural insurance markets from collapse;
• Encouraging insurers to serve rural communities;
• Ensuring seniors have affordable options without being forced into expensive plans.

Healthcare access should not depend on your ZIP code.

G. Restoring Control to Patients and Providers - Not HMOs

Healthcare decisions should be made by:

• Patients,
• Doctors,
• Hospitals and local providers,

-not by HMO corporations and federal bureaucrats.

My reform agenda will:

• Reduce insurer overreach into care decisions;
• Strengthen provider autonomy;
• Put Texans back in charge of their healthcare.

A Conservative Healthcare Revival Moment

Just as President Donald Trump delivered the first major tax reform since 1979, our nation now needs a bold, conservative healthcare revival - one that:

• Lowers costs,
• Expands choice,
• Protects rural communities,
• And restores free-market principles.

My healthcare reform plan will be the next major national reform, delivering real relief to Texans and setting the standard for the nation.

Bottom Line

As a Republican U.S. Senator from Texas, I will:

• Fight rising premiums,
• Break insurer monopolies,
• Expand affordable options,
• Protect small businesses and rural Texans,
• And put healthcare back in the hands of the people - not HMO corporations.