Monitoring the Session

HB 4076

Leach Bill Bans Transplant Denials Over Vaccination, Unless ‘Medically Significant’

Became law, effective Sep 1, 2025

Verdict: Smells

SmellsInitial review
Rep. Jeff LeachRHouse 67
Why it's charged
The hole

THE TEXT

“A physician who in good faith makes a determination that an individual's vaccination status is medically significant to the organ transplant, as described by Subsection (b), does not violate this section.”

Bill text, introduced version (I)

The bill's main case is a transplant patient turned away for being unvaccinated. Subsections (b) and (e) let that same denial stand whenever a physician decides in good faith that vaccination status is medically significant. The ban covers only decisions made 'solely' on status, and the text sets no penalty or enforcement path.

The hole

Initial review · graded Oct 20, 2026 · Headline, summary and grade are analysis of the bill text, not a finding about any person · How we grade

Caption

relating to prohibiting organ transplant recipient discrimination on the basis of vaccination status.

Caption from analyzed text · version I.

Summary

A doctor’s good-faith call that it matters lets the denial stand. No penalty, no enforcement.

The bill bars health care providers from denying an organ transplant, a referral, related services, or a waiting-list spot solely because of a patient's vaccination status. It covers transplant patients and every provider involved at each stage of the process, and it shields providers from penalties for following the rule. A physician can still use vaccination status if, after an individual evaluation, the physician decides in good faith that it is medically significant, and state health rules are due by January 1, 2026.

Receipt

The receipt

89R-HB4076 · 2025-03-07

SOLD BY

+ 58 coauthors

ITEM

relating to prohibiting organ transplant recipient discrimination on the basis of vaccination status.

WHAT IT DOES

A doctor’s good-faith call that it matters lets the denial stand. No penalty, no enforcement.

The bill bars health care providers from denying an organ transplant, a referral, related services, or a waiting-list spot solely because of a patient's vaccination status. It covers transplant patients and every provider involved at each stage of the process, and it shields providers from penalties for following the rule. A physician can still use vaccination status if, after an individual evaluation, the physician decides in good faith that it is medically significant, and state health rules are due by January 1, 2026.

CHARGES

[x] THE HOLEanalysis confidence 60%

THE TEXT

“A physician who in good faith makes a determination that an individual's vaccination status is medically significant to the organ transplant, as described by Subsection (b), does not violate this section.”

Bill text, introduced version (I)

The bill's main case is a transplant patient turned away for being unvaccinated. Subsections (b) and (e) let that same denial stand whenever a physician decides in good faith that vaccination status is medically significant. The ban covers only decisions made 'solely' on status, and the text sets no penalty or enforcement path.

TOTAL

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version E · source

Sources

Fiscal note · version E · May 19, 2025

No first-year general revenue figure available here.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

HISTORY

  1. Filed
  2. Read first time
  3. Referred to Public Health
  4. Scheduled for public hearing on . . .
  5. Considered in public hearing
  6. Testimony taken/registration(s) recorded in committee
  7. Left pending in committee
  8. Considered in formal meeting
  9. Reported favorably w/o amendment(s)
  10. Comte report filed with Committee Coordinator
  11. Committee report distributed
  12. Committee report sent to Calendars
  13. Considered in Calendars
  14. Placed on General State Calendar
  15. Read 2nd time
  16. Passed to engrossment
  17. Record vote RV#2415
  18. Statement(s) of vote recorded in Journal
  19. Read 3rd time
  20. Passed
  21. Record vote RV#2486
  22. Statement(s) of vote recorded in Journal
  23. Reported engrossed
  24. Received from the House
  25. Read first time
  26. Referred to Health & Human Services
  27. Posting rule suspended
  28. Scheduled for public hearing on . . .
  29. Considered in public hearing
  30. Testimony taken in committee
  31. Left pending in committee
  32. Considered in public hearing
  33. Vote taken in committee
  34. Reported favorably w/o amendments
  35. Committee report printed and distributed
  36. Co-sponsor authorized
  37. Placed on intent calendar
  38. Rules suspended-Regular order of business
  39. Vote recorded in Journal
  40. Record vote
  41. Read 2nd time & passed to 3rd reading
  42. Record vote
  43. Three day rule suspended
  44. Record vote
  45. Read 3rd time
  46. Passed
  47. Record vote
  48. Senate passage reported
  49. Reported enrolled
  50. Signed in the House
  51. Signed in the Senate
  52. Sent to the Governor
  53. Signed by the Governor
  54. Effective on 9/1/25
FILED UNDER

No verified beat found.

SIGNED FOR BY

House · 83 yea · 53 nay

Senate · 25 yea · 6 nay

Sources

House: Final passage · May 14, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

Senate: Final passage · May 23, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

All floor motions and other positions below.

Smells

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

CAMPAIGN PAID FOR BY

Donors

Not tied to this bill.

Sources

The author's campaign account only. Own money and internal transfers are separate on the member page.

Derived itemized flow · Oct 28, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Texans for Lawsuit Reform PAC$1,141,482.69

Texans for Lawsuit Reform PAC

$1,141,482.69

Cash
$555,000.00
Paid by others
$586,482.69
Total
$1,141,482.69
digital $316,766.74mail $154,662.95advertising $89,953.00polling $25,100.00

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Jun 25, 2025 to Oct 13, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101004498, 101024562, 101039760, 101044787, 101067510, 101072948.

Texas Conservative Majority PAC$273,017.05

Texas Conservative Majority PAC

$273,017.05

Cash
$35,000.00
Paid by others
$238,017.05
Total
$273,017.05
canvassing $150,000.00digital $70,627.07Other filed descriptions $16,666.67texting $723.31

Also funds 42 other sitting lawmakers.

Derived recipient stock · Jan 23, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Feb 9, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101039760, 101044787, 101067510, 101072948.

Republican Party of Texas$182,117.94

Republican Party of Texas

$182,117.94

Cash
$0.00
Paid by others
$182,117.94
Total
$182,117.94
mail $182,117.94

Also funds 12 other sitting lawmakers.

Derived recipient stock · Oct 31, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Sep 30, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101072948.

Money

Missing data does not establish zero giving. Display amounts are rounded.

×

Texans for Lawsuit Reform PAC

$1,141,482.69

Cash
$555,000.00
Paid by others
$586,482.69
Total
$1,141,482.69
digital $316,766.74mail $154,662.95advertising $89,953.00polling $25,100.00

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Jun 25, 2025 to Oct 13, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101004498, 101024562, 101039760, 101044787, 101067510, 101072948.

×

Texas Conservative Majority PAC

$273,017.05

Cash
$35,000.00
Paid by others
$238,017.05
Total
$273,017.05
canvassing $150,000.00digital $70,627.07Other filed descriptions $16,666.67texting $723.31

Also funds 42 other sitting lawmakers.

Derived recipient stock · Jan 23, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Feb 9, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101039760, 101044787, 101067510, 101072948.

×

Republican Party of Texas

$182,117.94

Cash
$0.00
Paid by others
$182,117.94
Total
$182,117.94
mail $182,117.94

Also funds 12 other sitting lawmakers.

Derived recipient stock · Oct 31, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Sep 30, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101072948.

Votes6

Senate May 23, 2025

Yea
25
Nay
6
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

The bill was read third time and was passed by the following vote: Yeas 25, Nays 6. (Same as previous roll call)

Published stock of positions for this vote, except where marked derived.

  • Yea: 25 (published)
  • Nay: 6 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 23, 2025

Yea
25
Nay
6
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

Senator Kolkhorst moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that HB 4076 be placed on its third reading and final passage. The motion prevailed by the following vote: Yeas 25, Nays 6.

Published stock of positions for this vote, except where marked derived.

  • Yea: 25 (published)
  • Nay: 6 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 23, 2025

Yea
25
Nay
6
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

The bill was read second time and was passed to third reading by the following vote: Yeas 25, Nays 6. (Same as previous roll call)

Published stock of positions for this vote, except where marked derived.

  • Yea: 25 (published)
  • Nay: 6 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 23, 2025

Yea
25
Nay
6
Present, not voting
Not printed
Absent
0
Excused
0
Names

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Sources

Senator Kolkhorst moved to suspend the regular order of business to take up for consideration HB 4076 at this time on its second reading: HB 4076, Relating to prohibiting organ transplant recipient discrimination on the basis of vaccination status. The motion prevailed by the following vote: Yeas 25, Nays 6.

Published stock of positions for this vote, except where marked derived.

  • Yea: 25 (published)
  • Nay: 6 (published)
  • Present, not voting: Not printed
  • Absent: 0 (derived from named list)
  • Excused: 0 (derived from named list)

Senate journal. Source snapshot 2026-10-19, Central time.

House May 14, 2025

Yea
83
Nay
53
Present, not voting
2
Absent
9
Excused
3
Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 2486

HB 4076 was passed by (Record 2486): 83 Yeas, 53 Nays, 2 Present, not voting.

Published stock of positions for this vote, except where marked derived.

  • Yea: 83 (published)
  • Nay: 53 (published)
  • Present, not voting: 2 (published)
  • Absent: 9 (derived from named list)
  • Excused: 3 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

House May 13, 2025

Yea
95
Nay
41
Present, not voting
2
Absent
2
Excused
10
Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 2415

HB 4076 was passed to engrossment by (Record 2415): 95 Yeas, 41 Nays, 2 Present, not voting.

Published stock of positions for this vote, except where marked derived.

  • Yea: 95 (published)
  • Nay: 41 (published)
  • Present, not voting: 2 (published)
  • Absent: 2 (derived from named list)
  • Excused: 10 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

Witnesses24
For
13
Against
6
On
5
Names

For

  • Make Texans Healthy Again2 registrations
  • Self6 registrations
  • Self; Texans for Medical Freedom1 registration
  • Self; Texans for medical freedom1 registration
  • Self; TEXANS FOR VACCINE CHOICE1 registration
  • Self; Texans for Vaccine Choice1 registration
  • Self; Texas Eagle Forum1 registration

Against

  • BIO (Biotechnology Innovation Organization)1 registration
  • Self3 registrations
  • Texas Healthcare and Bioscience Institute2 registrations

On

  • Self; University Transplant Institute1 registration
  • Texas Hospital Association2 registrations
  • Texas Medical Association1 registration
  • Texas Pediatric Society1 registration
Sources

24 parsed registrations across the loaded witness lists.

Derived stock of witness registrations. Repeated appearances count separately. Organizations and self-representation appear as printed.

House witness list. Source snapshot 2026-10-20, Central time.

Senate witness list. Source snapshot 2026-10-20, Central time.

Fiscal

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version E · source

Sources

Fiscal note · version E · May 19, 2025

No first-year general revenue figure available here.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

How this was graded

Analysis of text version I by claude-opus-5-5, Oct 20, 2026, against the published rubric.

Sources

Texas House · Filed Mar 7, 2025

06/20/2025 E Effective on 9/1/25

Texas Legislature Online · Introduced · House Committee Report · Engrossed · Senate Committee Report · Enrolled

Data snapshot Oct 26, 2026 at 4:19 AM CDT. Grades, charges, quotes and corrections follow the published record.

Coauthors
Sponsors
Cosponsors

House committee · Public Health · Committee vote 8 aye, 5 nay · Out of committee

Senate committee · Health & Human Services · Committee vote 7 aye, 1 nay, 1 absent · Out of committee

Subjects

Health Care Providers

Health--Other Diseases & Medical Conditions

DISCRIMINATION

IMMUNIZATIONS

ORGAN & TISSUE DONATIONS

HEALTH & HUMAN SERVICES COMMISSION

Text

The text as introduced · 406 words

89R15206 LRM-D

By: Leach
H.B. No. 4076

A BILL TO BE ENTITLED

AN ACT

relating to prohibiting organ transplant recipient discrimination

on the basis of vaccination status.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Subchapter S, Chapter 161, Health and Safety

Code, is amended by adding Section 161.474 to read as follows:

Sec. 161.474. DISCRIMINATION ON BASIS OF VACCINATION STATUS

PROHIBITED. (a) A health care provider may not, solely on the

basis of an individual's vaccination status:

(1) determine an individual is ineligible to receive

an organ transplant;

(2) deny medical or other services related to an organ

transplant, including evaluation, surgery, counseling, and

postoperative treatment;

(3) refuse to refer the individual to a transplant

center or other related specialist for evaluation or receipt of an

organ transplant; or

(4) refuse to place the individual on an organ

transplant waiting list or place the individual at a position lower

in priority on the list than the position the individual would have

been placed if not for the individual's vaccination status.

(b) Notwithstanding Subsection (a), a health care provider

may consider an individual's vaccination status when making a

treatment recommendation or decision solely to the extent that a

physician, following an individualized evaluation of the potential

transplant recipient, determines the vaccination status is

medically significant to the organ transplant. This section does

not require a referral or recommendation for, or the performance

of, a medically inappropriate organ transplant.

(c) This section applies to each stage of the organ

transplant process.

(d) A person may not take an adverse action or impose a

penalty of any kind against a health care provider based solely on

the fact that the health care provider complied with Subsection

(a).

(e) A physician who in good faith makes a determination that

an individual's vaccination status is medically significant to the

organ transplant, as described by Subsection (b), does not violate

this section.

(f) A health care provider may:

(1) develop alternative risk mitigation strategies,

including antibody testing, prophylactic treatments, and antiviral

therapy, in lieu of requiring a vaccination; and

(2) inform patients of the risks and benefits of

receiving a vaccination.

SECTION 2. Not later than January 1, 2026, the executive

commissioner of the Health and Human Services Commission shall

adopt any rules necessary to implement Section 161.474, Health and

Safety Code, as added by this Act.

SECTION 3. This Act takes effect September 1, 2025.