Birthright Citizenship and Plyler: A Legislative Solution

 

Birthright Citizenship and Plyler: A Legislative Solution

By James Scott Trimm 

 

Original Intent vs. Plain Text: The Birthright Citizenship Dilemma

There is a tension at the heart of the Fourteenth Amendment to the United States Constitution that has shaped more than a century of constitutional law.

On one hand, the historical intent of the amendment is clear. It was adopted in the aftermath of the Civil War to secure the civil and legal rights of newly freed slaves—ensuring that states could not deny them the basic protections of citizenship.

On the other hand, the actual wording of the amendment is far broader than that specific purpose.

The Citizenship Clause reads:

“All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens…”

That language does not mention freed slaves.
It does not limit itself to any particular class.
Instead, it speaks in universal terms: “all persons.”

This creates a fundamental question:

Should the Constitution be interpreted according to the specific problem it was written to solve—or according to the full scope of the words that were actually written?

The Supreme Court confronted that question directly in United States v. Wong Kim Ark.

In that case, the Court was asked whether a child born in the United States to non-citizen parents was a citizen under the Fourteenth Amendment. The Court answered yes, and in doing so, it anchored its reasoning not in a narrow reading of historical intent, but in the plain meaning of the text.

The Court emphasized that the phrase:

“subject to the jurisdiction thereof”

must be understood in a broad, largely geographic sense. If a person is born within the territory of the United States and is subject to its laws, then that person is within its jurisdiction.

The Court made this point unmistakably clear when it stated that:

it is “impossible to construe” the phrase “subject to the jurisdiction thereof” as narrower than the phrase “within its jurisdiction” elsewhere in the same amendment.

With that single interpretive move, the Court effectively resolved the tension in favor of text over intent.

Birthright citizenship was no longer tied to the specific historical purpose of protecting freed slaves. Instead, it was grounded in a general principle:

Birth within the territory, combined with jurisdiction, confers citizenship—except in a few narrow, historically recognized exceptions.

Those exceptions included:

• Children of foreign diplomats
• Children born to enemy forces occupying U.S. territory

Outside of those limited cases, the rule became clear and enduring:

If you are born here, and you are subject to U.S. law, you are a citizen.

This interpretation has shaped constitutional law ever since—and it is the foundation upon which later decisions, including debates over the rights of non-citizens, have been built.

But it all begins here:

With a tension between what the amendment was meant to do, and what its words actually allow it to do.

 

The Plyler Decision 

In 1982, the U.S. Supreme Court made a 5-4 landmark ruling that required Texas taxpayers to provide public education to persons who are in the country illegally. This case was Plyler v. Doe, 457 U.S. 202 (1982). The purpose of this paper is to provide a fresh approach for overturning this ruling.

The Plyler decision was rooted in an interpretation of Section 1 of the Fourteenth Amendment to the U.S. Constitution, which reads:

All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

This section may be broken down into the Citizenship Clause:

All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside.

And the Equal Protection Clause:

No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

In Wong Kim Ark, the Court said:

The words “in the United States, and subject to the jurisdiction thereof” in the first sentence of the Fourteenth Amendment of the Constitution must be presumed to have been understood and intended by the Congress which proposed the Amendment, and by the legislatures which adopted it, in the same sense in which the like words had been used by Chief Justice Marshall in the well-known case of The Exchange and as the equivalent of the words "within the limits and under the jurisdiction of the United States,” and the converse of the words “out of the limits and jurisdiction of the United States” as habitually used in the naturalization acts. This presumption is confirmed by the use of the word “jurisdiction” in the last clause of the same section of the Fourteenth Amendment, which forbids any State to “deny to any person within its jurisdiction the equal protection of the laws.” It is impossible to construe the words “subject to the jurisdiction thereof” in the opening sentence as less comprehensive than the words “within its jurisdiction” in the concluding sentence of the same section; or to hold that persons “within the jurisdiction” of one of the States of the Union are not “subject to the jurisdiction of the United States.”

 (United States v. Wong Kim Ark, 169 U.S. 649 (1898) at 687)

In the Plyler decision, the Court followed this connection and interpreted the phrase “any person within its jurisdiction” in the Equal Protection Clause through the parallel phrase in the Citizenship Clause, which reads “subject to the jurisdiction thereof.”

Appellants seek to distinguish our prior cases, emphasizing that the Equal Protection Clause directs a State to afford its protection to persons within its jurisdiction, while the Due Process Clauses of the Fifth and Fourteenth Amendments contain no such assertedly limiting phrase. In appellants’ view, persons who have entered the United States illegally are not “within the jurisdiction” of a State even if they are present within a State’s boundaries and subject to its laws. Neither our cases nor the logic of the Fourteenth Amendment support that constricting construction of the phrase “within its jurisdiction.” [Footnote 10] We have never suggested that the class of persons who might avail themselves of the equal protection guarantee is less than coextensive with that entitled to due process.

 (Plyler v. Doe, 457 U.S. 202 (1982) at 211)

 Footnote 10 to this statement reads:

Although we have not previously focused on the intended meaning of this phrase, we have had occasion to examine the first sentence of the Fourteenth Amendment, which provides that “[a]ll persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States. . . .” (Emphasis added.) Justice Gray, writing for the Court in United States v. Wong Kim Ark, 169 U.S. 649 (1898), detailed at some length the history of the Citizenship Clause, and the predominantly geographic sense in which the term “jurisdiction” was used. He further noted that it was:

“impossible to construe the words ‘subject to the jurisdiction thereof,’ in the opening sentence [of the Fourteenth Amendment], as less comprehensive than the words ‘within its jurisdiction,’ in the concluding sentence of the same section; or to hold that persons ‘within the jurisdiction’ of one of the States of the Union are not ‘subject to the jurisdiction of the United States.’”

This parallel allowed the Court to apply its ruling in Wong Kim Ark to the Plyler case. In Wong Kim Ark, the Court had said:

The foregoing considerations and authorities irresistibly lead us to these conclusions: the Fourteenth Amendment affirms the ancient and fundamental rule of citizenship by birth within the territory, in the allegiance and under the protection of the country, including all children here born of resident aliens, with the exceptions or qualifications (as old as the rule itself) of children of foreign sovereigns or their ministers, or born on foreign public ships, or of enemies within and during a hostile occupation of part of our territory, and with the single additional exception of children of members of the Indian tribes owing direct allegiance to their several tribes.

 (Wong Kim Ark, 169 U.S. at 693)

On this basis, the Court determined that since Wong Kim Ark did not fit into one of these common law exceptions, he was “subject to the jurisdiction thereof,” and his birthright citizenship was guaranteed under the Fourteenth Amendment. Therefore, illegal immigrants are also “within its jurisdiction” as described by the Fourteenth Amendment if they don’t fit any of these same common law exceptions. As such, they would be entitled to “equal protection” under the Fourteenth Amendment and therefore access to public school education.

 

The Legislative Solution

However, if persons who have crossed the border illegally could be shown to fall within one of these common law exceptions under Wong Kim Ark, they would not be “within its jurisdiction” and would not be entitled to “equal protection.” This would relieve Texas taxpayers of an obligation to fund education for persons who have crossed the southern border illegally.

One of the common law exceptions was articulated by the Court in Wong Kim Ark as “enemies within and during a hostile occupation of part of our territory.”

Article I, Section 10 of the United States Constitution states in its final paragraph:

No state shall, without the consent of Congress, lay any duty of tonnage, keep troops, or ships of war in time of peace, enter into any agreement or compact with another state, or with a foreign power, or engage in war, unless actually invaded, or in such imminent danger as will not admit of delay.

In U.S. v. Abbott (2023), Texas argued:

Nonetheless, the political question doctrine bars consideration of Texas’s “invasion” defense. Texas argues that it constructed the floating barrier pursuant to the Self-Defense Clause, U.S. Const. art. I, § 10, cl. 3, because it is being “invaded” by “[t]housands of aliens ․ including members of cartels,” and thus asks the Court to exempt Texas’s conduct from the RHA. To credit Texas’s allegation of invasion would be to make a policy decision on a topic the Supreme Court and Fifth Circuit have identified as a nonjusticiable political question.

In this case, Abbott ultimately prevailed in the United States Court of Appeals for the Fifth Circuit (USA v. Abbott, No. 23-50632), but the court did not rule on the “invasion” argument. Thus, the fact stands that the State of Texas has invoked Article I, Section 10 of the U.S. Constitution declaring an “actual invasion” along its southern border.

This declaration of an “actual invasion” in accordance with the U.S. Constitution classifies those who have crossed Texas’ border with Mexico illegally as within the common law exception articulated by the Court in Wong Kim Ark as “enemies within and during a hostile occupation of part of our territory.” As such, they are not “subject to the jurisdiction thereof” as understood in Wong Kim Ark and thus not “within its jurisdiction” and entitled to equal protection as understood in Plyler.

This is why it is time for legislative action. Congress and the State of Texas should enact a bill that formally recognizes large-scale illegal entry across the southern border as constituting an “actual invasion” within the meaning of Article I, Section 10 of the Constitution. Such legislation should further clarify that individuals entering under these conditions—particularly when facilitated by organized criminal networks—fall within the category already acknowledged by the Supreme Court in United States v. Wong Kim Ark as “enemies within” during a “hostile occupation” of territory. By grounding this classification in existing constitutional language and judicial precedent, such a bill would not attempt to rewrite the Fourteenth Amendment, but rather to apply its own framework consistently—defining the outer limits of “jurisdiction” in a way that reflects both the realities on the ground and the logic the Court has already established.

 

Conclusion

The issue before us is not whether the Fourteenth Amendment is valid, nor whether its protections are important. It remains one of the most vital achievements in American constitutional history.

The issue is how it has been interpreted.

Through United States v. Wong Kim Ark, the Supreme Court resolved the tension between intent and text in favor of a broad, geographic understanding of “jurisdiction.” Through Plyler v. Doe, that same reasoning was extended further—applying equal protection even to those unlawfully present in the country.

But in doing so, the Court also made something else clear:

Jurisdiction is not unlimited.

It has exceptions—explicitly recognized within the Court’s own reasoning.

That is where the path forward lies.

If the definition of “jurisdiction” has been expanded to include those unlawfully present, then it can also be examined, clarified, and properly limited according to the same legal framework the Court itself has already established.

Texas has already raised the constitutional question. The courts have declined to resolve it. The executive branch has attempted to act—but cannot redefine the Constitution on its own.

Which leaves us with a simple but unavoidable reality:

The meaning of “jurisdiction” under the Fourteenth Amendment remains unresolved at its outer boundaries.

This is why it is time for legislative action.

Congress and the State of Texas should enact a bill that formally recognizes large-scale illegal entry across the southern border as constituting an “actual invasion” within the meaning of Article I, Section 10 of the Constitution. Such legislation should further clarify that individuals entering under these conditions—particularly when facilitated by organized criminal networks—fall within the category already acknowledged by the Supreme Court in United States v. Wong Kim Ark as “enemies within” during a “hostile occupation” of territory.

By grounding this classification in existing constitutional language and judicial precedent, such a bill would not attempt to rewrite the Fourteenth Amendment, but rather to apply its own framework consistently—defining the outer limits of “jurisdiction” in a way that reflects both the realities on the ground and the logic the Court has already established.

This is not a call to ignore precedent.

It is a call to apply it consistently.

Because the same logic that expanded the meaning of “jurisdiction” can—and should—be used to define its limits.

A Texas Solution to Artificial Drug Shortages How State Sovereignty Can Protect Chronic Pain Patients

 

 

A Texas Solution to Artificial Drug Shortages

How State Sovereignty Can Protect Chronic Pain Patients 

by James Scott Trimm

 

Across the United States, millions of chronic pain patients are facing a problem that has nothing to do with medicine and everything to do with government policy: artificial drug shortages.

These shortages are not caused by a lack of medical knowledge or an inability to manufacture medication. In many cases, they are the result of federal manufacturing quotas imposed by the Drug Enforcement Administration (DEA) on medications that are already approved as safe and effective by the Food and Drug Administration (FDA).

Patients suffer. Doctors are constrained. Pharmacies run out of medication.

And all of it happens because a federal agency has decided to limit how much medicine can legally be produced.

In Texas, it is time to ask a simple question:

Why should Texans be forced to suffer because of federal manufacturing quotas?

Beyond the immediate medical consequences, these federal manufacturing quotas raise a broader question about economic freedom and state sovereignty. Texas has long embraced the principles of free enterprise, open markets, and the ability of businesses to respond to legitimate demand. Yet under the current federal quota system, pharmaceutical manufacturers are prevented from responding to real medical needs simply because a federal agency has predetermined how much medication may exist in the marketplace.

This situation creates an artificial scarcity that harms patients while simultaneously preventing businesses from meeting demand. In a free market system, shortages invite increased production. Under the federal quota system, however, shortages simply persist.

For a state like Texas, which has built its economic success on the belief that markets work best when supply can respond to demand, this situation presents both a challenge and an opportunity.

The Problem: “Operation Bottleneck”

For years, chronic pain patients and physicians have warned about what many now call “Operation Bottleneck.”

Under current federal policy, the DEA establishes annual manufacturing quotas for certain medications, particularly opioid-based pain treatments. These quotas determine how much of a drug can legally be produced in the United States.

Even if there is legitimate medical demand.

Even if doctors prescribe responsibly.

Even if patients have documented medical need.

Once the quota is reached, manufacturers cannot legally produce more of the medication.

The result is predictable:

• Pharmacies cannot obtain medication.
• Doctors are forced to alter stable treatment plans.
• Patients experience uncontrolled pain or forced withdrawal.

In other words, federal policy has created a government-imposed bottleneck in the medical supply chain.

What makes this situation particularly troubling is that the medications affected by these quotas are not experimental or untested. They are medications that have already undergone extensive safety and efficacy review by the FDA and have been used responsibly for years in the treatment of legitimate medical conditions.

Yet the federal quota system treats supply as a law-enforcement variable rather than a medical one. Instead of allowing supply to respond to legitimate demand within the healthcare system, production is artificially limited at the national level.

For patients living with severe chronic pain, the consequences of these policies are not abstract. They are immediate and deeply personal.

A Texas Idea  Inspired by a Texas Law

Texas has already explored similar constitutional ideas before.

In 2021, Texas passed legislation asserting that firearm suppressors manufactured and retained entirely within Texas are not subject to federal regulation under the interstate commerce power.

The legal theory was straightforward:

If something is manufactured in Texas and never enters interstate commerce, then it falls within the sovereign regulatory authority of the State of Texas.

Whether courts ultimately accept that argument or not, the law established an important principle:

Texas does not have to help enforce federal policies that harm Texans.

That idea inspired a new proposal.

Texas has often led the nation in developing innovative policy solutions that respect both constitutional federalism and economic opportunity. By examining how intrastate commerce principles could be applied to pharmaceutical manufacturing, Texas has the opportunity to address a pressing healthcare problem while also reinforcing its commitment to free markets and economic growth.

A Bill Written by  P.A.R.T. Texas

P.A.R.T. Texas — Pain Awareness Right to Treatment — has written a proposed bill that applies this same concept to the medical supply chain.

The legislation would allow FDA-approved medications to be manufactured entirely within Texas for use only within Texas.

This proposal does not attempt to bypass FDA safety approval.

The medications involved would already be approved by the FDA as safe and effective.

The issue is not safety.

The issue is federal manufacturing limits imposed by the DEA that artificially restrict supply.

Under the proposal:

• Texas manufacturers could produce FDA-approved medications within the state.
• Those medications would remain entirely inside Texas.
• They would be clearly labeled “Made in Texas — Intrastate Use Only.”

In other words, Texas would ensure that necessary medications can be manufactured to meet legitimate patient demand within the state.

In addition to addressing the supply problem directly, the legislation would also create a more stable regulatory environment for pharmaceutical manufacturers operating in Texas. Companies seeking to produce medications that are already FDA-approved would have the opportunity to expand operations within the state without being constrained by national quota systems that do not reflect local medical demand.

Economic Opportunity
for Texas

The potential benefits of this policy extend well beyond healthcare.

Encouraging pharmaceutical manufacturing within Texas could attract significant investment in new manufacturing facilities, research operations, and distribution infrastructure. Pharmaceutical production is a high-skilled, high-value sector that creates well-paying jobs and stimulates broader economic growth in surrounding communities.

Texas has long demonstrated that when businesses are given the freedom to operate within a stable regulatory environment, investment follows. The state has become a national leader in industries ranging from energy and technology to aerospace and advanced manufacturing.

By allowing intrastate pharmaceutical manufacturing, Texas could position itself as a leader in another critical sector of the modern economy.

Instead of allowing federal quotas to suppress supply, Texas could encourage companies to expand production capacity where legitimate demand exists. This would strengthen the state’s economy while simultaneously addressing a pressing healthcare need.

Helping Texans
Return to Work

The economic benefits of improved access to pain treatment extend beyond manufacturing.

Millions of Americans living with chronic pain are not unwilling to work. Many are unable to work because their medical conditions are not adequately treated.

When patients lose access to effective treatment, the consequences ripple outward. Workers leave the workforce. Families lose income. Disability claims increase. Employers lose experienced employees whose skills and knowledge are difficult to replace.

Improving access to legitimate medical treatment can help some Texans regain stability and independence. For many patients, effective pain management can mean the difference between permanent disability and the ability to participate in the workforce again.

In this way, policies that restore access to necessary medications can also strengthen the broader economy by enabling more citizens to contribute productively to their communities.

Non-Cooperation With Harmful Federal Policies

The proposed legislation also includes a key constitutional mechanism: state non-cooperation.

Texas agencies, employees, and political subdivisions would be prohibited from assisting federal enforcement actions that conflict with the intrastate pharmaceutical system established by the bill.

This reflects the long-recognized anti-commandeering principle of American constitutional law:

The federal government may enforce its own laws, but it cannot require states to enforce them.

Texas therefore has the authority to say:

Texas will regulate the medical care of its own citizens.

Legal Protection for Doctors, Pharmacists,
and Patients

The bill also includes a powerful protection mechanism.

It requires the Texas Attorney General to defend:

• Texas pharmaceutical manufacturers
• prescribing physicians
• pharmacists and dispensers
• insurers complying with Texas law
• Texas residents acting within the law

against federal enforcement actions that attempt to interfere with the state’s intrastate pharmaceutical system.

The Attorney General would be authorized to:

• seek injunctions and declaratory relief
• intervene in federal court proceedings
• provide legal representation
• fund legal defense where appropriate

In other words, Texans acting in compliance with Texas law to provide legitimate medical care would not be left alone to face federal litigation.

The State of Texas itself would stand behind them.

A Free-Market and Medical Freedom Solution

At its core, this proposal reflects principles long embraced in Texas:

• limited government
• free markets
• respect for the doctor-patient relationship
• compassion for those who suffer

Artificial manufacturing quotas imposed by a federal agency violate all four.

If a medication has already been approved by the FDA and there is legitimate medical demand for it, there should be no bureaucratic bottleneck preventing its production.

Allowing manufacturers to respond to demand is not only good medicine; it is also consistent with the economic principles that have helped make Texas one of the most dynamic economies in the United States.

Why This Matters

According to federal public health data:

• More than 50 million Americans live with chronic pain.
• Millions experience severe, life-limiting pain.

These are not abstract numbers.

They are our neighbors.

Our family members.

Our friends.

Many simply want to live with dignity and manage their medical conditions under the care of their doctors.

They should not be collateral damage in a federal quota system.

A Texas Path Forward

Texas has never been a state that waits for Washington to solve its problems.

When federal policies harm Texans, the state has both the authority and the responsibility to act.

The legislation written by P.A.R.T. Texas offers one possible path forward — restoring access to necessary medications while defending the rights of doctors and patients.

Sometimes the solution is straightforward.

If a medication is:

• approved for medical use
• manufactured in Texas
• prescribed by Texas physicians
• dispensed by Texas pharmacies
• and used by Texas patients

then Texans should not be denied access because of a federal manufacturing quota.

Texas can — and should — ensure that the medical needs of its citizens come first.

Addendum: Texas Leads — Other States Can Follow

Texas has often served as a proving ground for policies that later spread across the nation. When a state identifies a problem that harms its citizens and develops a lawful and principled solution, that solution does not need to stop at its borders.

The legislation proposed by P.A.R.T. Texas is designed first and foremost to protect Texans suffering from chronic pain and other serious medical conditions. However, the underlying principle is not unique to Texas.

Every state has citizens who depend on medically necessary medications.

Every state has physicians trying to care for their patients responsibly.

And every state is affected by federal manufacturing quotas that can restrict the supply of medications regardless of legitimate medical demand.

If Texas demonstrates that an intrastate pharmaceutical manufacturing system can restore access to necessary medications while maintaining safety standards and respecting the doctor-patient relationship, there is no reason other states cannot adopt similar policies.

Federal systems often change only after the states lead the way.

Texas has the opportunity to start that process.

If this approach proves successful, other states may choose to enact their own intrastate pharmaceutical manufacturing laws, creating a broader movement to ensure that Americans suffering from chronic pain and other serious conditions are not denied treatment because of artificial supply limits.

Texas can lead.

Others can follow.

And together, the states can help restore a medical system that puts patients first.

You can help this work by donating to P.A.R.T. Texas by donating here:

 https://parttexas.com/donations/fundraising-campaign/

Disclosure: The author serves as President of P.A.R.T. Texas, a 501(c)(4) nonprofit organization advocating for the rights of chronic pain patients and the physicians who treat them. He has been involved in conservative political activism in Texas for more than forty years and previously served as a legislative staffer.

You can view the actual bill here:

 https://parttexas.com/wp-content/uploads/2026/03/Break-the-Bottleneck-Act.pdf

 

Restoring Consent: A New Bill to Protect Communities from Unilateral School District Splits

 

Restoring Consent: A New Bill to Protect Communities from Unilateral School District Splits

James Scott Trimm 

About a year ago, residents of the Keller Independent School District were confronted with a proposal that stunned the community. Behind closed doors, members of the school board advanced a plan to fundamentally restructure the district—first by renaming it “Alliance ISD,” and then by splitting it into two separate districts, one of which would reclaim the name “Keller ISD.” This was not a minor administrative adjustment. It was a sweeping structural transformation affecting governance, taxation, school zoning, and the identity of the community itself. And it was attempted without a vote of the people.

From the beginning, that fact alone set off alarm bells across the community. The central issue was not simply whether the proposal was wise or unwise, or whether a split might have long-term benefits or drawbacks. The issue was that it was being advanced at all without a mechanism for voter approval. A school board has authority to administer a district. It does not have authority to redefine the district itself without the consent of those who live within it. The proposed split would have reallocated hundreds of millions of dollars in assets and liabilities, redrawn attendance boundaries, altered governance structures, and changed the long-term financial obligations of taxpayers. These are legislative-level decisions in substance, even if they originate at the local level. Yet the people most affected—parents, taxpayers, and voters—were never given a binding vote. That is not a procedural oversight. It is a failure of first principles.

The 2024 Republican Party of Texas Platform is not vague on this point. It explicitly affirms that government properly exists by the consent of the governed. That principle is not decorative language. It is the foundation of republican government itself. The platform reinforces this idea in multiple ways, calling for limits on government power, affirming the central role of parents in education, and emphasizing accountability and transparency in public decision-making. And yet, in Keller ISD, a small group of officials attempted to carry out a transformational restructuring without ever seeking that consent. There was no referendum, no binding vote, and no mechanism by which the governed could actually govern. That is not self-government. That is authority substituting itself for consent.

By the time the public became aware of the proposal, it had already progressed beyond preliminary discussion. Reporting indicates that Tim Davis represented Keller ISD during the split effort and was alleged to have been involved in developing its legal framework. If accurate, that suggests the proposal had moved into structured planning before the public was ever brought into the conversation. Then came a sequence of events that is difficult to ignore. On March 10, 2025, State Representative David Lowe filed Texas House Bill 4156, legislation addressing the creation of new school districts by detachment and requiring a structured process including voter approval. Just four days later, on March 14, the Keller ISD split was abruptly abandoned.

The reasons given for that reversal were substantial. The district was carrying approximately $700 million in outstanding bond debt, and any division would have required complex and costly allocation of that obligation. At the same time, the Texas Education Agency had begun reviewing complaints regarding governance and transparency. The superintendent had already resigned in opposition to the plan. Each of these factors, standing alone, would have raised serious concerns. Taken together, they made the proposal untenable. But they do not answer the deeper question raised by the episode: how did a plan of this magnitude advance so far without the consent of the people?

The legislative response that followed demonstrated that this concern was widely recognized. House Bill 4156 was not left standing alone. On May 15, 2025, State Representative Charlie Geren filed Texas House Bill 5089, an identical measure reinforcing the same framework. State Representative Nate Schatzline publicly emphasized the importance of community voice, transparency, and accountability, explicitly framing the Keller ISD outcome as an example of the will of the people being heard. And yet, despite that recognition, neither bill ultimately became law. HB 4156 was never granted a hearing. HB 5089 was unanimously approved in committee, but died in the Calendars Committee as the legislative session ran out of time. The issue was acknowledged. The solution was partially constructed. But the work was not completed.

That is why this issue must be addressed again in the next legislative session. The failure of those bills was not a failure of principle. It was a failure to fully develop and carry forward a solution that matches the seriousness of the problem. With decades of involvement in legislative activism, including time working as a legislative staffer, I have seen how legislation can fall short—not because the idea is wrong, but because it is not fully formed or sufficiently grounded. For that reason, I have taken the step of drafting a new bill that builds on what was started, corrects its weaknesses, and provides a more complete and defensible framework.

The original bill made important improvements to the process, particularly in requiring petitions and elections. But it remained largely procedural. It did not explicitly anchor itself in the foundational principles that justify those procedures. It left significant discretion to administrative bodies in the allocation of assets and liabilities, relying on the vague concept of “equitable” division rather than a clear, objective standard. And it did not directly address the constitutional risks that arise when structural changes produce unequal access to educational resources.

The new bill addresses each of these shortcomings directly. It begins by stating clearly that the creation of a new school district by detachment must be grounded in the consent of the governed, drawing directly from the principles and language of the 2024 Republican Party of Texas Platform. It makes explicit that local governing bodies possess only delegated authority and may not unilaterally redefine political boundaries. It affirms the role of parents and voters in decisions that directly affect the education of their children, consistent with the platform’s emphasis on parental rights, limited government, and accountability. These are not rhetorical additions. They are statements of legislative intent that guide how the law must be interpreted and applied.

Where the prior bill relied on subjective notions of equity in dividing assets and liabilities, the new bill adopts a clear, objective formula modeled on Wisconsin Statute 66.0235. Assets and debts are allocated proportionally based on taxable property value, using certified appraisal data. This removes ambiguity, limits discretion, and provides a standard that is predictable and defensible. At the same time, the bill preserves local flexibility by allowing districts to adopt an alternative arrangement—but only if both sides agree through identical resolutions approved by a three-fourths supermajority. That ensures that any deviation from the formula reflects genuine consensus, not unilateral advantage.

The new bill also addresses a critical issue that the prior legislation left largely untouched: equal protection. It does so carefully and narrowly. It does not impose quotas, demographic targets, or ideological frameworks. Instead, it simply requires that any proposed detachment not materially diminish the ability of any group of students to access substantially equal educational opportunity. At the same time, it explicitly states that the law does not require demographic balancing or forced redistribution. The purpose is not to engineer outcomes, but to prevent actions that would clearly violate the constitutional guarantee of equal protection under the law.

Finally, the bill reinforces the principle of mutual consent. A new district may be created only if it is approved both by voters in the detaching territory and by voters in the remaining district. This ensures that no community can be divided unilaterally, and that both sides of the proposed change have a voice in the outcome. It restores balance to a process that, as Keller demonstrated, can otherwise move forward without meaningful public input.

Keller ISD was the catalyst for this effort, but it is not the only place where such a situation could arise. The underlying issue is structural. Without clear statutory safeguards, similar proposals can emerge elsewhere, advancing rapidly and only later coming to public attention. That is not how republican government is meant to function. Structural changes of this magnitude require more than administrative approval. They require the consent of the governed.

This bill is an effort to restore that principle in a clear, enforceable, and constitutionally grounded way. It does not attempt to micromanage local decisions. It does not impose ideological mandates. It simply establishes a framework in which major structural changes cannot occur without the knowledge, participation, and approval of the people who will live with the consequences.

The full text of the new bill appears below.

A BILL TO BE ENTITLED

AN ACT

relating to creation of a school district by detachment of territory from an existing school district.

---

WHEREAS

WHEREAS, government derives its just powers from the consent of the governed; and

WHEREAS, decisions that fundamentally alter the structure, boundaries, or governance of a political subdivision must be subject to the approval of the voters directly affected; and

WHEREAS, the authority of local governing bodies is limited to powers delegated by the people and does not extend to unilateral restructuring of political boundaries without voter approval; and

WHEREAS, parents have a fundamental interest in the education of their children, including the governance and structure of the school districts in which their children are educated; and

WHEREAS, transparency and accountability in public decision-making require that major structural changes be subject to open processes and direct voter consent;

---

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

SECTION 1. LEGISLATIVE INTENT

Sec. 13.099.

(a) It is the intent of the legislature that any creation of a school district by detachment of territory be grounded in the consent of the voters residing in the affected areas.

(b) A governmental body may not unilaterally alter the boundaries or structure of a school district without providing a meaningful opportunity for voter approval.

(c) This subchapter shall be construed to:

• preserve the right of voters to approve or reject structural changes to their local school district;
• ensure that parental interests are represented in decisions affecting the education of their children; and
• promote transparency, accountability, and public participation in the governance of school districts.

SECTION 2. DEFINITIONS

Sec. 13.100.

• "Board" means the State Board of Education.
• "Detaching territory" means the geographic area proposed to be removed from an existing district to form a new district.

SECTION 3. INITIATION OF DETACHMENT

Sec. 13.103.

(a) Creation of a new district by detachment is initiated by a petition presented to the board.

(b) A petition must:

• describe the metes and bounds of the proposed district;
• be signed by at least 20 percent of the registered voters residing in the detaching territory within each affected district; and
• be addressed to the board.

(c) The petition must include:

• a general statement of the educational and financial impact of the proposed detachment; and
• a proposed plan for governance and transition.

SECTION 4. HEARING AND ELECTION

Sec. 13.104.

(a) Not later than the 30th day after receiving a petition, the board shall hold a public hearing to determine its validity.

(b) If valid, the board shall order an election to be held on the same date in:

• the detaching territory; and
• the remaining territory of each affected district.

(c) The ballot shall permit voters to approve or reject the creation of the new district.

(d) The new district is created only if:

• a majority of votes in the detaching territory favor creation; and
• a majority of votes in the remaining territory of each affected district favor creation.

SECTION 5. CREATION OF DISTRICT; ASSETS AND LIABILITIES

Sec. 13.105.

(a) If all requirements of this subchapter are met, the board shall adopt a rule creating the new district.

(b) The board shall appoint a board of seven trustees for the new district to serve until the next regular election of trustees.

(c) Proportional Allocation — Default Rule

The board shall assign assets and liabilities proportionally based on taxable property values using certified appraisal data.

(d) Alternative Agreement by Supermajority

Districts may agree to a different allocation if approved by identical resolutions with a three-fourths vote of each board.

(e) Equity Safeguards

• No district may be materially impaired;
• Allocation must be equitable to taxpayers.

(f) Property Transfer

Property in the detaching territory transfers to the new district unless otherwise agreed.

(g) Debt Allocation

The new district assumes its share of outstanding indebtedness.

(h) Equal Protection

No detachment may materially diminish equal educational opportunity.

(i) Prohibited Effect

No detachment may create disparities based on race or socioeconomic status.

(j) Limiting Construction

This section does not require demographic balancing or forced redistribution.

SECTION 6. EFFECTIVE DATE

This Act takes effect September 1, 2027.

 

SD-9 Delegates Removed from the Texas GOP Convention for Upholding Party Platform Principles

Opposition to the Keller ISD split without a public vote put grassroots Republicans at odds with party leadership—and cost them their place as delegates.

---

About a year ago, residents of the Keller Independent School District were confronted with a proposal that stunned the community. Behind closed doors, members of the school board advanced a plan to fundamentally restructure the district—first by renaming it “Alliance ISD,” and then by splitting it into two separate districts, one of which would reclaim the name “Keller ISD.” This was not a minor administrative adjustment, but a sweeping structural transformation affecting governance, taxation, school zoning, and the identity of the community itself.

And it was attempted without a vote of the people.

From the beginning, that fact alone set off alarm bells across the community. This was not a routine administrative decision. It was a proposal that would permanently alter the structure of a public institution, redistribute resources, redraw boundaries, and reshape the educational landscape for thousands of families. Yet the people most affected—the parents, taxpayers, and voters—were not given a direct say in whether it should happen.

The plan ultimately collapsed under intense public pressure. But what followed made clear that this was not merely a local controversy. It exposed a deeper dividing line within the Republican Party itself: between those willing to move forward without consent, and those insisting that our stated principles actually mean what they say.

The 2024 Republican Party of Texas Platform is not vague on this point. It explicitly affirms that “government properly exists by the consent of the governed” (Plank 11) . That is not rhetorical flourish. It is the foundation of republican government itself. And yet, in Keller ISD, a small group of officials attempted to carry out a transformational restructuring without ever seeking that consent. There was no referendum, no binding vote, no mechanism by which the governed could actually govern.

That is not self-government. That is authority substituting itself for consent.

The platform reinforces this principle in multiple ways. It calls for limiting government power to its proper bounds (Principles §4) , yet a school board’s authority to administer a district does not extend to redefining the district itself without the people. It affirms that parental rights are foundational (Plank 17) , yet a decision directly affecting where children attend school and how resources are allocated was advanced without giving parents the deciding voice. And it emphasizes accountability in the exercise of authority (Plank 10) , yet this proposal emerged from closed-door discussions, only becoming public after it had already taken shape.

By the time the public became aware of the proposal, it had already moved beyond casual discussion. Reporting indicates that Tim Davis represented Keller ISD during the split effort and was alleged to have been instrumental in developing the legal strategy behind it. If accurate, that suggests the effort had progressed into structured planning and execution before the public was ever brought into the conversation. That alone raises serious questions—not just about the proposal itself, but about the process used to develop it.

Then came a sequence of events that is difficult to ignore.

On March 10, 2025, State Representative David Lowe filed House Bill 4156, legislation addressing the creation of new school districts by detachment and ensuring that such actions would require a structured process, including voter approval. Just four days later, on March 14, the Keller ISD split was abruptly abandoned.

The stated reasons were financial and administrative. The district faced approximately $700 million in existing bond debt, and a split would require tens of millions in additional funding to allocate that debt fairly. At the same time, the Texas Education Agency had begun reviewing complaints regarding the district’s governance, including concerns about transparency. The superintendent had already resigned in opposition to the plan.

Each of these factors is significant. Together, they raise a simple and unavoidable question: why did a plan that had advanced so far collapse so quickly?

This article does not speculate. But the timeline speaks for itself.

What followed is just as important.

House Bill 4156 was not an isolated effort. It was reinforced at the state level. On May 15, 2025, State Representative Charlie Geren filed House Bill 5089, an identical measure. State Representative Nate Schatzline publicly emphasized the importance of community voice, transparency, and accountability, explicitly framing the outcome in Keller ISD as an example of the will of the people being heard.

This matters.

Because it demonstrates that the demand for a referendum was not a fringe reaction or a temporary political position. It was a position shared and advanced by conservative Republican legislators—and it was entirely consistent with the principles laid out in the Republican Party platform.

In other words, the dividing line is clear.

Those who sought to split the district without a vote were acting contrary to our stated principles.

Those who insisted on a referendum were acting in alignment with them.

I write this not as an outside observer, but as someone directly involved at the time. I was serving as District Director for State Representative David Lowe, and in that capacity I addressed the Keller ISD School Board twice on his behalf—first to state clearly that a decision of this magnitude should not be conducted without a general referendum, and then to announce that he would be filing legislation to require such a vote. I was also personally engaged in the issue, speaking out publicly as these events unfolded, and I was proud to do so—upholding the conservative principles of our Party Platform.

What I saw firsthand were not citizens resisting solutions, but citizens insisting on process—parents and taxpayers who understood something fundamental: that how a decision is made matters just as much as the decision itself.

Because process is not secondary.

Process is the safeguard of principle.

That is why what happened next is so troubling.

According to reporting by the Fort Worth Star-Telegram, several Republicans who opposed the Keller ISD split were later removed from the delegate list for the Texas GOP Convention.

We voted in the Republican primary.
We attended our precinct convention.
We followed the rules.

And yet we were excluded.

My wife and I were ultimately excluded from serving as delegates after I publicly opposed the Keller ISD split and advocated for a referendum—raising serious questions about whether adherence to the Republican Party Platform is being treated as a disqualifying position.

I have spent more than four decades working within the Republican Party in Texas—as a grassroots volunteer, precinct chair, campaign worker, strategist, and legislative staffer. My involvement dates back to the early 1980s, including work on campaigns such as Charlie Evans for State Representative and the Pat Robertson campaign in 1988. I later served as a Precinct Chair in Tarrant County, a member of the County Executive Committee’s Resolutions Committee, and a consultant helping recruit and support Republican candidates at the grassroots level.

My work has also included serving as a strategist, advisor, and campaign manager for State Representative David Lowe, working in the political department of the Don Huffines campaign, and serving as District Director in the Texas House. I have also contributed to policy development as a Bill Analyst for Texas Policy Research, focusing on legislation grounded in limited government, individual liberty, and free enterprise.

My wife and I have consistently supported Republican candidates and causes throughout that time.

Neither of us has ever supported a Democrat—openly or otherwise.

Taken together, these events raise a serious question—not just about a school district, but about the integrity of process itself.

What happens when the public is excluded from a decision of this magnitude?

What happens when that decision is developed without transparency?

And what happens when those who object—on principled, platform-based grounds—are later excluded from participation?

The people of Keller ISD answered part of that question.

They stopped the split.

They insisted on being heard.

And in doing so, they upheld the very principle the platform proclaims: consent of the governed.

The legislators who called for a vote upheld it as well.

The lesson is simple, but it is not optional.

If we are serious about our platform, then we must be consistent.

We cannot claim to believe in consent of the governed, limited government, parental rights, and accountability—and then set those principles aside when they become inconvenient.

Because if those principles do not apply here—

then where do they apply?

A Breakthrough for Medical Freedom in Texas - Chronic Pain Resolution Passes in Three Senatorial District Conventions

 

A Breakthrough for Medical Freedom in Texas

Chronic Pain Resolution Passes in Three Senatorial District Conventions

By James Scott Trimm

Today marks a significant turning point in the effort to restore medical freedom for chronic pain patients in Texas. What began as a grassroots concern raised at the precinct level has now advanced through three separate Senatorial District Conventions, signaling that this issue is no longer isolated or easily ignored.

Across the state, delegates in SD 9, SD 16, and SD 30 each considered versions of the P.A.R.T. Texas Chronic Pain Resolution. These were not coordinated rubber-stamp actions, but independent deliberations by separate bodies of grassroots activists. Yet all three arrived at the same essential conclusion: current policy governing chronic pain treatment is not working, and it must be corrected.

In SD 9, the resolution was adopted without alteration as a new platform plank. In SD 16, a slightly modified version was adopted, also as a new platform plank. In SD 30, a version of the resolution itself was adopted and included in the official Resolutions Report. While the forms varied slightly, the substance remained intact. Across three districts, the same message emerged — the doctor–patient relationship must be restored, and the rights of chronic pain patients must be protected.

This level of convergence is not accidental. It reflects a growing recognition among grassroots conservatives that something has gone fundamentally wrong in the way chronic pain is treated in this country. For years, policy in this area has drifted away from the principles of limited government and individual liberty, and toward a system dominated by regulatory pressure, corporate compliance, and bureaucratic control.

All three of these Senatorial Districts will now forward their adopted versions of the resolution to the Texas Republican Party Resolutions Committee, where they will be considered for inclusion in the 2026 Texas Republican Party Platform at the State Convention in June. This is how the platform is built — not from the top down, but from the ground up, beginning with ordinary delegates who recognize a problem and take action to address it.

And just as importantly, this is how legislation begins.

In Texas, the party platform is not merely symbolic. It serves as a roadmap for lawmakers heading into the next legislative session. When an issue rises from the precinct level, is adopted at multiple Senatorial District Conventions, and is ultimately incorporated into the state party platform, it creates both political momentum and institutional support for legislative action.

In other words, what happened today is not the end of the process — it is the beginning of it.

If this plank is adopted at the State Convention, it will pave the way for legislation to be filed in the next session of the Texas Legislature. This is how the system is designed to work: a concern raised by grassroots Texans moves through the party structure, becomes a platform priority, and is then translated into concrete legislative proposals.

The importance of this moment becomes even clearer when viewed in the broader context. As previously discussed , the current regulatory environment surrounding chronic pain treatment represents a departure from core conservative principles. Federal prescribing guidelines, originally intended to be advisory, have been transformed in practice into binding rules. They are enforced not through legislation, but through a web of regulatory agencies, insurance requirements, pharmacy policies, and corporate compliance structures. In effect, law has been created without a vote.

The consequences of this shift have been profound. Physicians who once treated chronic pain patients according to their professional judgment now practice under constant pressure and scrutiny. Many have stopped treating pain altogether. Patients who were stable for years under legitimate medical care have found their treatment reduced or eliminated, not because of individual medical need, but because of external rules imposed far outside the exam room.

This system rests on a narrative that does not withstand careful examination. While prescription-related overdose deaths did rise in the early 2000s, they peaked more than a decade ago. The ongoing crisis in overdose deaths has been driven primarily by illicit substances — especially fentanyl and other synthetic opioids — often in combination with stimulants and other drugs. Chronic pain patients and their physicians were not the primary drivers of this crisis, yet they have borne the brunt of the policy response.

From a conservative perspective, this raises a fundamental question: why is government power being directed at lawful patients and doctors instead of the illicit drug market? When policy harms responsible individuals without solving the underlying problem, it is not merely ineffective — it is unjust.

What the resolutions passed today represent is a reassertion of principle. They affirm that medical decisions should be made by patients in consultation with their physicians. They insist that guidelines must remain advisory rather than becoming de facto law. They call for protections for both patients seeking lawful treatment and physicians acting in good faith according to sound medical judgment. These are not radical ideas. They are consistent with the longstanding conservative commitment to limited government, personal responsibility, and individual liberty.

The progress seen today did not occur in a vacuum. It reflects the work of P.A.R.T. Texas (Pain Awareness Right to Treatment), which has sought to bring this issue into focus and give a voice to those who have too often been overlooked. Chronic pain patients are not statistics, and they are not abstractions in a policy debate. They are individuals — Texans — whose lives have been profoundly affected by decisions made far from their own circumstances.

The road ahead remains critical. At the State Convention in June, delegates will determine whether these resolutions become part of the official platform of the Texas Republican Party for 2026. From there, the next step is clear: translating that platform into legislation that restores balance, protects patients, and reestablishes the doctor–patient relationship as the foundation of medical care.

What happened today demonstrates that this issue is gaining traction where it matters most — at the grassroots level. It shows that delegates across multiple districts are recognizing the same problem and moving in the same direction. And it confirms that the pathway from concern to policy to law is not theoretical — it is actively unfolding.

For millions of Texans living with chronic pain, this is more than a procedural step. It is the beginning of a process that can lead to real, tangible change. And for those who believe in the principles of limited government and individual liberty, it is a reminder that those principles must apply consistently — including in the exam room.

The movement to restore medical freedom in Texas has not reached its conclusion.

But after today, it has clearly entered its next phase.

Disclosure: The author serves as President of P.A.R.T. Texas, a 501(c)(4) nonprofit organization advocating for the rights of chronic pain patients and the physicians who treat them. He has been involved in conservative political activism in Texas for more than forty years and previously served as a legislative staffer.

 

The Platform Plank as passed in SD 9

Healthcare Independence

Chronic Pain Care

NEW PLANK

Texans suffering from chronic or intractable pain should have access to compassionate, individualized treatment without unnecessary government interference. Federal prescribing guidelines must remain advisory, not binding. We support protecting the doctor-patient relationship, defending physicians acting in good faith, and ensuring that healthcare decisions remain grounded in personal responsibility, sound medical judgment, and limited government.

 

The Platform Plank as it passed in SD 16

Health and Human Services

Medical Freedom & Informed Consent

NEW PLANK: “Medical Freedom and Chronic Pain”

Be it resolved that federal policies that limit availability of opioids and other pain medicines that prevent access to properly prescribed pain medicine by legitimate, law-abiding pain patients must be reversed.

Be it further resolved that the doctor-patient relationship must be protected, and physicians that act in good faith must be defended from bad government protocols, in order to ensure that healthcare decisions remain grounded in personal responsibility, sound medical judgment, and limited government.

 

The Resolution as it passed in SD 30

 

Resolution Supporting Medical Freedom for Chronic Pain Patients and Their Physicians

WHEREAS, the Republican Party has long championed limited government, individual liberty, personal responsibility, and respect for the doctor-patient relationship; and

WHEREAS, medical freedom is a fundamental component of personal liberty, ensuring that Texans can make healthcare decisions in consultation with their physicians without unnecessary government interference; and

WHEREAS, Texans suffering from chronic or intractable pain deserve access to compassionate, individualized medical care that preserves their dignity, independence, and quality of life; and

WHEREAS, governmental and non-governmental prescribing guidelines intended as advisory recommendations have been treated as binding rules by employers, regulators, insurers, and pharmacies, undermining medical judgment and restricting otherwise legal and legitimate patient care; and

WHEREAS, misapplied governmental and non-governmental guidelines unnecessarily impede physicians from treating chronic pain patients, leaving many Texans without effective treatment for their pain despite responsible compliance with medical advice;

---

THEREFORE, BE IT RESOLVED, that the Republican Party of Texas affirms its strong support for medical freedom, limited government, and personal responsibility in healthcare decision-making for patients with chronic pain; and

BE IT FURTHER RESOLVED, that we support policies ensuring that governmental and nongovernmental prescribing guidelines for chronic pain remain advisory rather than de facto law within Texas; and

BE IT FURTHER RESOLVED, that we support legislative protections for chronic pain patients seeking lawful treatment and for healthcare providers acting in good faith according to sound medical judgment; and

BE IT FINALLY RESOLVED, that the Republican Party calls upon Texas lawmakers to safeguard medical freedom and protect the doctor-patient relationship from unnecessary intrusion while promoting responsible, ethical medical care for chronic pain consistent with the principles of liberty and accountability.

A Milestone for Medical Freedom in Texas

 

 

A Milestone for Medical Freedom in Texas
Precinct Conventions Advance Resolution Supporting Chronic Pain Patients and Their Physicians

By James Scott Trimm

Last night marked an important milestone in the growing movement to restore medical freedom for chronic pain patients in Texas.

At Republican precinct conventions in both Tarrant County and Dallas County, delegates passed a resolution supporting the rights of chronic pain patients and the physicians who treat them. The resolution will now move forward to the 9th and 16th Senatorial District Conventions, where it will be considered for advancement to the Texas Republican Party State Convention as a potential platform plank.

For millions of Texans living with chronic or intractable pain, this moment represents something many have not felt in years: hope.

For too long, chronic pain policy has been shaped by fear, bureaucracy, and one-size-fits-all guidelines that often override the judgment of physicians and the needs of individual patients. Federal prescribing guidelines that were originally intended to be advisory have too often been treated as if they were binding law, leading insurers, pharmacies, and regulators to impose rigid restrictions that were never approved by Congress and never intended to function as hard limits.

The result has been devastating for many patients.

Across Texas and the nation, responsible patients who followed their doctors’ instructions have seen treatments abruptly reduced or eliminated. Physicians who once provided compassionate care have been pressured to stop treating pain altogether. Many Texans now struggle simply to find a doctor willing to help them manage legitimate medical conditions.

The resolution adopted last night addresses this crisis directly.

It reaffirms core conservative principles — limited government, individual liberty, personal responsibility, and respect for the doctor–patient relationship — and calls for policies ensuring that federal guidelines remain advisory rather than being treated as de facto law.

It also calls for legislative protections for both patients seeking lawful treatment and physicians acting in good faith according to sound medical judgment.

In other words, it restores a principle that should never have been abandoned: medical decisions belong in the exam room, not in distant bureaucracies.

Texas is home to millions of people living with chronic pain.

National public-health estimates show that approximately 51–55 million Americans live with chronic pain, and 17–20 million suffer from high-impact chronic pain that significantly limits their daily activities.

Texas represents roughly 9 percent of the U.S. population. When that ratio is applied to national health data, the implications are staggering.

An estimated 4.6 to 5 million Texans live with chronic pain.

Among them, roughly 1.5 to 1.8 million Texans suffer from severe, life-limiting pain that affects their ability to work, function, and live normal lives.

These are not small numbers. These are not fringe cases.

They are our neighbors, our coworkers, our parents, our spouses, and our friends.

And when you include the family members who care for and support them, the number of Texans directly touched by chronic pain easily reaches into the tens of millions.

This is not a marginal issue in Texas.

It is one of the largest and least-represented medical-freedom issues in the state.

The resolution that passed at precinct conventions states:

Resolution Supporting Medical Freedom for Chronic Pain Patients and Their Physicians

WHEREAS, the Republican Party has long championed limited government, individual liberty, personal responsibility, and respect for the doctor-patient relationship; and

WHEREAS, medical freedom is a fundamental component of personal liberty, ensuring that Texans can make healthcare decisions in consultation with their physicians without unnecessary government interference; and

WHEREAS, Texans suffering from chronic or intractable pain deserve access to compassionate, individualized medical care that preserves their dignity, independence, and quality of life; and

WHEREAS, federal prescribing guidelines intended as advisory recommendations have often been treated as binding rules by regulators, insurers, and pharmacies, undermining medical judgment and restricting legitimate patient care; and

WHEREAS, excessive regulation discourages physicians from treating chronic pain patients, leaving many Texans without effective treatment despite responsible compliance with medical advice;

THEREFORE, BE IT RESOLVED, that the Republican Party of Texas affirms its strong support for medical freedom, limited government, and personal responsibility in healthcare decision-making; and

BE IT FURTHER RESOLVED, that we support policies ensuring federal guidelines remain advisory rather than de facto law within Texas; and

BE IT FURTHER RESOLVED, that we support legislative protections for chronic pain patients seeking lawful treatment and for healthcare providers acting in good faith according to sound medical judgment; and

BE IT FINALLY RESOLVED, that the Republican Party calls upon Texas lawmakers to safeguard medical freedom and protect the doctor-patient relationship from unnecessary regulatory intrusion while promoting responsible, ethical medical care consistent with the principles of liberty and accountability.

This resolution did not appear out of thin air. It is the result of growing grassroots concern from Texans who recognize that chronic pain policy has drifted far from the principles of liberty and responsible medical care.

Helping to spearhead this effort is P.A.R.T. Texas (Pain Awareness Right to Treatment), a new 501(c)(4) organization dedicated to defending the rights of chronic pain patients and the physicians who treat them.

P.A.R.T. Texas is working to bring attention to the unintended consequences of current policy and to promote solutions grounded in both compassion and common sense. The organization believes that Texans suffering from serious medical conditions should not be treated as suspects simply for seeking relief from pain, and that physicians should be free to practice medicine according to their professional judgment without fear of unnecessary regulatory retaliation.

The adoption of this resolution at the precinct level represents an important first step. In the Republican Party of Texas, precinct conventions are where grassroots activists begin shaping the ideas that eventually become party platform planks and legislative priorities.

Last night’s votes show that the issue of medical freedom for chronic pain patients is beginning to resonate with grassroots conservatives.

The resolution now moves to the senatorial district conventions, and if adopted there, it could advance to the state convention where delegates will determine the official platform of the Republican Party of Texas.

The road ahead remains long, but last night demonstrated something powerful:

Texans are beginning to recognize that defending the doctor–patient relationship and protecting the dignity of chronic pain patients is not a fringe issue.

It is a liberty issue.

And the movement to restore that liberty has begun.

— James Scott Trimm

Disclosure: The author serves as President of P.A.R.T. Texas, a 501(c)(4) nonprofit organization advocating for the rights of chronic pain patients and the physicians who treat them. He has been involved in conservative political activism in Texas for more than forty years and previously served as a legislative staffer.

Freedom vs. the Nanny State: Why Conservatives Should Stand Up for Chronic Pain Patients

 

 

Freedom vs. the Nanny State: 
Why Conservatives Should Stand Up for Chronic Pain Patients
By
James Scott Trimm

 

For conservatives and libertarians, the issue of chronic-pain treatment should not be controversial.
It should be obvious.

Over the last decade, Americans have watched the steady expansion of government power into areas that were once considered private, personal, and beyond the reach of bureaucracy. Nowhere has this overreach been more visible than in the exam room, where federal agencies, insurers, pharmacies, and corporate policies increasingly dictate medical decisions that should belong to patients and their physicians.

Instead of trusting individuals and doctors, the system has adopted a paternalistic mindset:

We know what’s best for you — even if you suffer for it.

This strikes directly at core conservative values:

• personal freedom

• bodily autonomy

• limited government

• personal responsibility

• the sanctity of the doctor–patient relationship

From a conservative perspective, current chronic-pain policy is not just bad medicine.
It is bad governance.

It represents the nanny state at its worst — overriding medical judgment, restricting lawful treatment, and placing bureaucratic rules above human dignity.

This is a medical-freedom issue, and conservatives should start treating it like one.

---

When Guidelines Become Law Without a Vote

For most of American history, medical decisions were made by patients and doctors, not by federal regulators.

That changed during the opioid panic of the early 2000s.

Federal agencies issued prescribing guidelines that were supposed to be advisory. They were never passed by Congress, never voted on by the public, and never intended to function as hard limits.

Yet in practice, those guidelines became de facto law.

Regulators enforced them.
Insurance companies enforced them.
Pharmacies enforced them.
Corporate policies enforced them.

Doctors who treated pain aggressively were investigated.
Patients who needed medication were treated as suspects.
Stable, responsible people were forced to taper off treatments that had worked for years.

Instead of individualized care, we got one-size-fits-all rules.

Instead of medical judgment, we got algorithms.

Instead of freedom, we got control.

Conservatives have warned for decades about exactly this kind of government overreach.
On this issue, those warnings turned out to be right.

---

The Narrative That Justified the Crackdown

The entire system of restrictions rests on one claim:

Prescription pain medication caused the overdose crisis.

That claim has been repeated so often that many people assume it must be true.

But the government’s own data tells a different story.

According to CDC, NCHS, and NIDA mortality statistics, prescription-involved overdose deaths rose in the early 2000s, peaked around 2010, and then leveled off or declined. Meanwhile, total overdose deaths continued to rise dramatically, driven not by prescriptions, but by illicit drugs — especially fentanyl.

Consider the shift:

• In 1999, synthetic opioids like fentanyl were involved in fewer than 1,000 deaths.

• By 2023, synthetic opioids were involved in tens of thousands of deaths per year.

• Prescription-involved deaths remained relatively stable after their peak.

Even at their highest point, prescription deaths were only a fraction of total overdose deaths.

The modern overdose crisis was not driven by chronic-pain patients or their doctors.

It was driven by the illegal drug market.

---

The Real Crisis: Fentanyl, Meth, Cocaine, and Polysubstance Deaths

The pattern over the last twenty-five years is clear.

Prescription deaths rose early, then plateaued.
Heroin deaths rose for a time, then declined.
Synthetic fentanyl exploded.
Stimulant deaths surged.
Polysubstance deaths became the norm.

Methamphetamine deaths increased more than thirty-fold since the late 1990s.
Cocaine deaths rose sharply after the mid-2010s.
A majority of overdose deaths now involve more than one drug.

CDC reports show that many stimulant deaths also involve fentanyl, meaning people are not dying from one substance, but from unpredictable mixtures in the illicit supply.

This is a poisoned-drug crisis, not a prescription-drug crisis.

Yet policy did not focus on the illegal market.

Instead, it focused on the easiest target:

Doctors and patients who were following the law.

---

Chronic Pain Patients Became Collateral Damage

As the crackdown intensified, the people who suffered most were not criminals.

They were chronic-pain patients.

People with spinal injuries.
People with nerve damage.
People with degenerative disease.
People with cancer.
People who simply wanted to live without constant agony.

Many had been stable for years under responsible medical care.

Then the rules changed.

Doctors were pressured to cut doses.
Pharmacies refused to fill prescriptions.
Insurance companies denied coverage.
Patients were labeled high-risk simply for needing treatment.

Some were forced into withdrawal.
Some turned to the street out of desperation.
Some lost the ability to work, function, or live normally.
Some did not survive.

All of this happened while overdose deaths kept rising.

When policy hurts innocent people without solving the problem, conservatives should ask a simple question:

Why is government doing this at all?

---

Medical Freedom Is a Conservative Principle

The Republican Party has long stood for limited government, individual liberty, and respect for personal responsibility. Those principles should apply to healthcare as much as to any other area of life.

Medical freedom means:

Patients should make decisions with their doctors.
Guidelines should not become mandates.
Physicians should not practice in fear of regulators.
States should not surrender authority to federal bureaucracy.
Policy should be based on facts, not panic.

These principles are not radical.

They are consistent with everything conservatives say they believe.

And they point toward reforms that restore balance instead of expanding control.

---

A Conservative Approach to Reform

Policy discussions in Texas and elsewhere are increasingly focused on restoring the proper balance between safety and freedom.

Proposals being discussed include protections for the doctor-patient relationship, limits on corporate and bureaucratic interference, stronger due-process protections for physicians, safeguards for patient privacy, and recognition of the state’s authority to regulate medical practice under the Tenth Amendment.

These ideas do not promote abuse.

They promote responsibility.

They recognize that adults should be treated like adults, and doctors like professionals, not suspects.

They reflect a simple principle:

Government should not stand between a suffering patient and lawful medical care.

---

Time for Conservatives to Reclaim This Issue

For too long, the debate over pain treatment has been framed as a choice between public safety and personal freedom.

That is a false choice.

We can fight illegal drugs without punishing legitimate patients.
We can reduce overdoses without destroying the doctor-patient relationship.
We can protect communities without turning federal agencies into the nation’s medical supervisors.

Conservatives should not be afraid to say this.

Freedom does not stop at the exam-room door.

And if we truly believe in limited government, personal responsibility, and individual liberty, then defending the rights of chronic-pain patients is not a liberal issue, not a partisan issue, and not a fringe issue.

It is a conservative one.

- James Scott Trimm 

Disclosure:The author serves as President of P.A.R.T. Texas, a 501(c)(4) nonprofit organization defending the rights of chronic pain patients and the physicians who treat them. He has been involved in conservative political activism in Texas for more than forty years and previously served as a legislative staffer.