republic-os/legislation/us/states/tx/89r/hb-18.md

---
type: "Bill"
title: "Relating to the establishment and administration of certain programs and services providing health care services to rural counties."
description: "Relating to the establishment and administration of certain programs and services providing health care services to rural counties."
jurisdiction: "us/states/tx"
legislature: "Texas Legislature"
session: "89R"
identifier: "HB 18"
citation: "Texas HB 18 (89R)"
classification: ["bill"]
subjects: ["Disaster Preparedness & Relief (I0211)", "Education--Higher--Health Institutions (I0237)", "HEALTH & HUMAN SERVICES COMMISSION (V0177)", "Health Care Providers (I0387)", "Health--Rural (I0381)", "Hospitals (I0400)", "Human Services--Medical Assistance (I0905)", "Minors--Health & Safety (I0533)", "RURAL HEALTH STABILIZATION & INNOVATION ACT (P52B0)", "STAFF DEVELOPMENT & TRAINING (S0317)", "STATE OFFICE OF RURAL HOSPITAL FINANCE (VE2AY)", "State Agencies", "Boards & Commissions--Newly Proposed (I0773)", "State Finances--Appropriations (I0746)", "State Finances--Management & Control (I0748)"]
status: "enacted"
primary_sponsors: ["Ashby", "Johnson", "King", "Lambert", "Perry", "VanDeaver"]
version_count: 5
action_count: 76
vote_count: 8
first_action: "2025-03-07"
last_action: "2025-06-20"
source: "openstates"
source_identifier: "ocd-bill/31487576-390e-4a25-a7f4-11e99a419faf"
source_url: "ftp://ftp.legis.state.tx.us/bills/89R/billhistory/house_bills/HB00001_HB00099/HB 18.xml"
source_hash: "4128292052ac235e799b386a06a5707959214729f79ae1d6f3d0e1c260a1d25b"
vintage: "2026-07-01"
source_snapshot: "https://data.openstates.org/daily/2026-07-01/public.pgdump"
retrieved_at: "2026-07-06"
confidence: "reported"
tags: ["legislation", "bill", "us-tx"]
---

# Texas HB 18 (89R) — Relating to the establishment and administration of certain programs and services providing health care services to rural counties.

## Version chain

The bill's text revisions, in order — the diff chain from filing to enrollment.

1. **Introduced** (filed) — [source](http://capitol.texas.gov/tlodocs/89R/billtext/html/HB00018I.HTM)
2. **Engrossed** (committee substitute) — [source](http://capitol.texas.gov/tlodocs/89R/billtext/html/HB00018E.HTM)
3. **House Committee Report** (committee substitute) — [source](http://capitol.texas.gov/tlodocs/89R/billtext/html/HB00018H.HTM)
4. **Senate Committee Report** (committee substitute) — [source](http://capitol.texas.gov/tlodocs/89R/billtext/html/HB00018S.HTM)
5. **Enrolled** (enrolled) — [source](http://capitol.texas.gov/tlodocs/89R/billtext/html/HB00018F.HTM)

## Votes

- passage — **115–18** (pass) · lower
- passage — **26–5** (pass) · upper
- other — **9–22** (fail) · upper
- Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that CSHB 18 be placed on its third reading and final passage. — **26–5** (pass) · upper
- passage — **26–5** (pass) · upper
- passage — **115–18** (pass) · upper
- passage — **119–24** (pass) · lower
- passage — **106–33** (pass) · lower

## Sponsors

- Ashby — primary (person)
- Johnson — primary (person)
- King — primary (person)
- Lambert — primary (person)
- Perry — primary (person)
- VanDeaver — primary (person)
- Blanco — cosponsor (person)
- Bonnen — cosponsor (person)
- Buckley — cosponsor (person)
- Flores — cosponsor (person)
- Guillen — cosponsor (person)
- Hagenbuch — cosponsor (person)
- Harris — cosponsor (person)
- Hinojosa, Juan "Chuy" — cosponsor (person)
- Kolkhorst — cosponsor (person)
- Landgraf — cosponsor (person)
- Metcalf — cosponsor (person)
- Sparks — cosponsor (person)
- Spiller — cosponsor (person)

## Timeline

The legislative action history — every referral, reading, and vote.

- **2025-03-07** Filed `filing`
- **2025-03-10** Read first time `introduction, reading-1`
- **2025-03-10** Referred to Public Health `referral-committee`
- **2025-03-24** Considered in public hearing
- **2025-03-24** Committee substitute considered in committee `substitution`
- **2025-03-24** Testimony taken/registration(s) recorded in committee
- **2025-03-24** Left pending in committee
- **2025-04-07** Considered in public hearing
- **2025-04-07** Committee substitute considered in committee `substitution`
- **2025-04-07** Reported favorably as substituted `committee-passage-favorable`
- **2025-04-14** Comte report filed with Committee Coordinator `filing`
- **2025-04-14** Committee report distributed
- **2025-04-15** Committee report sent to Calendars
- **2025-04-17** Considered in Calendars
- **2025-04-22** Placed on General State Calendar
- **2025-04-22** Read 2nd time `reading-2`
- **2025-04-22** Postponed
- **2025-04-22** Laid out as postponed business
- **2025-04-22** Postponed
- **2025-04-23** Laid out as postponed business
- **2025-04-23** Amendment(s) offered `amendment-introduction`
- **2025-04-23** Point of order withdrawn (amendment) `withdrawal`
- **2025-04-23** Amendment withdrawn `amendment-withdrawal, withdrawal`
- **2025-04-23** Amended `amendment-passage`
- **2025-04-23** Record vote
- **2025-04-23** Statement(s) of vote recorded in Journal
- **2025-04-23** Passed to engrossment as amended `amendment-passage`
- **2025-04-23** Record vote
- **2025-04-23** Statement(s) of vote recorded in Journal
- **2025-04-24** Read 3rd time `reading-3`
- **2025-04-24** Passed `passage`
- **2025-04-24** Record vote
- **2025-04-24** Statement(s) of vote recorded in Journal
- **2025-04-24** Reported engrossed
- **2025-04-24** Received from the House `introduction`
- **2025-04-28** Read first time `introduction, reading-1`
- **2025-04-28** Referred to Health & Human Services `referral-committee`
- **2025-05-07** Scheduled for public hearing on . . .
- **2025-05-07** Co-sponsor authorized
- **2025-05-07** Considered in public hearing
- **2025-05-07** Testimony taken in committee
- **2025-05-07** Left pending in committee
- **2025-05-13** Considered in public hearing
- **2025-05-13** Vote taken in committee
- **2025-05-19** Reported favorably as substituted `committee-passage-favorable`
- **2025-05-19** Committee report printed and distributed
- **2025-05-21** Co-sponsor authorized
- **2025-05-21** Placed on intent calendar
- **2025-05-25** Co-sponsor authorized
- **2025-05-25** Rules suspended-Regular order of business
- **2025-05-25** Record vote
- **2025-05-25** Read 2nd time `reading-2`
- **2025-05-25** Amendment(s) offered `amendment-introduction`
- **2025-05-25** Amendment fails of adoption `amendment-failure`
- **2025-05-25** Record vote
- **2025-05-25** Passed to 3rd reading
- **2025-05-25** Record vote
- **2025-05-25** Three day rule suspended
- **2025-05-25** Record vote
- **2025-05-25** Read 3rd time `reading-3`
- **2025-05-25** Passed `passage`
- **2025-05-25** Record vote
- **2025-05-26** Senate passage as amended reported `amendment-passage`
- **2025-05-26** Senate Amendments distributed
- **2025-05-26** Senate Amendments Analysis distributed
- **2025-05-28** House concurs in Senate amendment(s)
- **2025-05-28** Record vote
- **2025-05-28** Statement(s) of vote recorded in Journal
- **2025-05-28** Text of Senate Amendment(s)
- **2025-05-28** House concurs in Senate amendment(s)-reported
- **2025-05-29** Reported enrolled `enrolled`
- **2025-05-30** Signed in the House `passage`
- **2025-05-31** Signed in the Senate `passage`
- **2025-05-31** Sent to the Governor `executive-receipt`
- **2025-06-20** Signed by the Governor `executive-signature`
- **2025-06-20** Effective immediately `became-law`

## Source

OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/31487576-390e-4a25-a7f4-11e99a419faf`. Confidence: reported (aggregated from official Texas legislature records).