Healthcare

Ken Paxton (R)

Paxton has 'gone after the ACA in court numerous times and has long opposed the law,' per Tribune reporting. He has not publicly addressed the 2025 expiration of the ACA enhanced premium tax credits, projected to drop hundreds of thousands of Texans from coverage. He has vigorously defended Texas's near-total abortion ban with its fertilization-onward fetal personhood definition and has not commented on Trump's IVF accessibility plan. He sued the Biden administration in 2024 to block CMS nursing-home minimum staffing rules, arguing they would force rural facilities to close. In Sept. 2025 he won a federal ruling striking down a CMS rule that would have expanded federal oversight of state Medicaid funding mechanisms.

James Talarico (D)

Talarico's signature proposal is a Medicare buy-in open to every American at any age as a not-for-profit public option competing with private insurance. He would restore the ACA enhanced premium tax credits, save rural hospitals through better Medicare/Medicaid reimbursement, regulate PBMs, reform prior authorization, and ban medical debt on credit reports. He would codify Roe v. Wade, protect contraception and IVF, and oppose VA privatization while expanding veterans' mental health services. In Austin he capped insulin co-pays at $25/month after his own diabetic-ketoacidosis diagnosis (a $684 first prescription), passed Canadian drug-import legislation, and used a procedural point of order to kill a bill that would have cut Medicaid coverage. He has framed Republican healthcare cuts as 'a moral crime' that will cause '51,000 Americans to die needlessly.'

Healthcare

Ken Paxton (R)

James Talarico (D)

Sources