Rural healthcare in Texas is in crisis — but nurse practitioners are helping lead the way toward solutions. In a recent op-ed published this week, Texas Nurse Practitioners (TNP) President Tracy Hicks highlights how nurse practitioners are uniquely positioned to close care gaps and strengthen rural health systems across the state.
Since 2010, 20 rural hospitals have closed in Texas, and more than 34 counties have no physician at all. Nearly half of Texas counties are considered maternity care deserts, and the state ranks last in the nation for access to mental health services. These alarming statistics underscore the urgency of expanding access to care in rural communities.
In the piece, Hicks points to the Rural Health Transformation Program, established under the One Big Beautiful Bill Act (OBBBA), as a rare opportunity for Texas to reimagine its rural healthcare system. TNP recently submitted a proposal to the Texas Health and Human Services Commission (HHSC) under this program, emphasizing the expansion of nurse practitioner-led models that deliver immediate, sustainable access to care.
The TNP proposal calls for:
- Establishing rural NP-led clinics, mobile health units, and integrated behavioral health models;
- Investing in workforce development through rural fellowships, clinical placements, and loan repayment programs—particularly in mental and maternal health;
- Expanding telehealth infrastructure to reach remote communities; and
- Modernizing outdated practice laws that restrict NPs’ ability to provide care.
“Nurse practitioners are the providers who show up, stay put, and keep our communities healthy,” Hicks writes. “With proper support, NPs can continue to be the backbone of a resilient rural health system.”
As the state prepares its application for the Rural Health Transformation Program, TNP continues to advocate for solutions that meet Texans where they are and ensure every community has access to high-quality, timely, and affordable care.
