Health & Hospital Districts
75 Health & Hospital Districts reported $5,423,123,255 of principal outstanding at the end of fiscal year 2025.
| Issuer? | County? | Principal outstanding, FY 2025? | Debt service outstanding? | Issues? |
|---|---|---|---|---|
| Bexar County Hospital District (University Health System) | Bexar | $1,247,585,000 | $1,965,092,360 | 7 |
| Harris County Hospital District | Harris | $1,064,940,000 | $1,941,688,098 | 5 |
| El Paso County Hospital District | El Paso | $589,225,000 | $986,925,058 | 4 |
| Dallas County Hospital District | Dallas | $511,285,000 | $828,432,874 | 2 |
| Tarrant County Hospital District | Tarrant | $435,595,000 | $779,111,777 | 3 |
| Midland County Hospital District (Midland Memorial) | Midland | $217,750,000 | $350,340,160 | 4 |
| Travis County Healthcare District | Travis | $157,670,000 | $222,510,438 | 5 |
| Decatur Hospital Authority | Wise | $106,556,000 | $163,085,773 | 4 |
| Joint Guadalupe County-City of Seguin Hospital Board of Managers | Guadalupe | $97,735,000 | $158,124,306 | 1 |
| Irving Hospital Authority | Dallas | $92,645,000 | $146,574,822 | 3 |
| OakBend Medical Center | Fort Bend | $68,244,367 | $114,761,886 | 4 |
| Uvalde County Hospital Authority | Uvalde | $57,930,000 | $66,974,826 | 2 |
| Nacogdoches County Hospital District | Nacogdoches | $45,845,249 | $67,956,405 | 4 |
| Hunt Memorial Hospital District | Hunt | $45,425,000 | $59,296,998 | 4 |
| Fredericksburg Hospital Authority | Gillespie | $40,000,000 | $64,966,667 | 1 |
| Karnes County Hospital District | Karnes | $35,293,000 | $56,640,435 | 2 |
| Moore County Hospital District | Moore, Hartley, Sherman | $34,209,628 | $49,873,214 | 5 |
| Gainesville Hospital District | Cooke | $30,730,000 | $43,513,104 | 1 |
| Coryell County Memorial Hospital Authority | Coryell | $29,535,610 | $45,388,951 | 5 |
| Olney-Hamilton Hospital District | Young | $27,832,000 | $59,356,997 | 3 |
| Sweeny Hospital District | Brazoria | $26,796,256 | $37,351,964 | 1 |
| Ector County Hospital District | Ector | $26,640,000 | $34,010,900 | 1 |
| Seminole Hospital District | Gaines | $25,475,000 | $29,326,741 | 2 |
| Harris Center for MHIDD | Harris | $24,745,000 | $42,072,494 | 1 |
| Reagan Hospital District | Reagan | $22,275,000 | $31,118,572 | 1 |
| Hutchinson County Hospital District | Hutchinson | $20,350,000 | $30,749,493 | 3 |
| Deaf Smith County Hospital District | Deaf Smith | $20,000,000 | $27,617,675 | 1 |
| Andrews County Hospital District | Andrews | $19,575,000 | $23,071,400 | 2 |
| McCamey Hospital District | Upton | $17,465,000 | $25,737,985 | 1 |
| Nolan County Hospital District | Nolan | $16,146,000 | $20,834,525 | 3 |
| Jack County Hospital District | Jack | $14,675,000 | $17,382,958 | 2 |
| Coleman County Medical Center District | Coleman | $14,222,000 | $20,450,864 | 3 |
| Gonzales Healthcare Systems | Gonzales | $13,531,230 | $19,002,802 | 1 |
| Comanche County Cons Hospital District | Comanche | $12,837,750 | $17,926,471 | 2 |
| Mitchell County Hospital District | Mitchell | $12,815,000 | $22,217,444 | 1 |
| Titus County Memorial Hospital District | Titus | $12,751,667 | $15,874,480 | 5 |
| Hemphill County Hospital District | Hemphill | $12,215,000 | $18,929,316 | 1 |
| Martin County Hospital District | Martin | $12,050,000 | $15,134,200 | 1 |
| Tri-County Behavioral Healthcare | Walker, Montgomery, Liberty | $11,920,000 | $20,756,198 | 1 |
| Schleicher County Hospital District | Schleicher | $11,000,000 | $14,939,808 | 1 |
| Hondo Hospital Authority | Medina | $9,963,000 | $14,866,129 | 4 |
| Collin County MHMR Center | Collin | $9,630,175 | $12,046,863 | 1 |
| Scurry County Hospital District | Scurry | $8,813,000 | $10,097,705 | 3 |
| Kimble County Hospital District | Kimble | $8,615,000 | $10,367,075 | 1 |
| Castro County Hospital District | Castro | $8,539,665 | $12,563,081 | 1 |
| Metrocrest Hospital Authority | Dallas | $8,101,772 | $9,067,062 | 2 |
| Heart of Texas Regional MHMR Center | McLennan | $7,360,000 | $10,254,244 | 1 |
| Iraan General Hospital District | Pecos | $6,555,000 | $8,099,100 | 1 |
| Dawson County Hospital District | Dawson | $6,200,000 | $7,014,031 | 2 |
| McCulloch County Hospital District (Heart of Texas Memorial) | McCulloch | $5,483,662 | $8,561,562 | 1 |
| North Wheeler County Hospital District | Wheeler | $5,450,000 | $6,750,813 | 1 |
| Rankin Hospital District | Upton | $5,338,000 | $6,466,253 | 1 |
| Wilson County Memorial Hospital District | Wilson | $4,925,000 | $5,372,738 | 2 |
| Parmer County Hospital District | Parmer | $4,870,000 | $5,208,142 | 1 |
| Texana Center (MHMR) | Fort Bend, Austin, Colorado, Matagorda, Waller, Wharton | $3,995,000 | $5,765,696 | 1 |
| Angleton-Danbury Hospital District | Brazoria | $3,905,000 | $4,133,563 | 1 |
| Collingsworth County Hospital District | Collingsworth | $3,737,000 | $4,975,248 | 1 |
| Dallam-Hartley Counties Hospital District | Dallam, Hartley | $3,721,000 | $4,884,362 | 2 |
| West Wharton County Hospital District | Wharton | $3,404,000 | $5,167,929 | 1 |
| Hamilton Hospital District | Hamilton | $3,260,000 | $3,809,126 | 2 |
| Baylor County Hospital District | Baylor | $2,825,000 | $3,216,847 | 2 |
| Stonewall County Hospital District | Stonewall | $2,392,000 | $2,742,175 | 1 |
| Bellville Hospital District | Austin | $2,059,666 | $2,754,803 | 1 |
| Camino Real MHMR | Atascosa | $2,010,000 | $2,288,053 | 1 |
| Muenster Hospital District | Cooke | $1,789,996 | $2,892,425 | 2 |
| Culberson County Hospital District | Culberson | $1,721,000 | $1,772,710 | 1 |
| Ochiltree County Hospital District | Ochiltree | $1,266,000 | $1,418,492 | 1 |
| Rice Hospital District | Colorado | $1,090,000 | $1,788,743 | 1 |
| Reeves County Hospital District | Reeves | $729,000 | $750,829 | 1 |
| Travis County Emergency SD 06 | Travis | $705,000 | $738,228 | 1 |
| Behavioral Health Center of Nueces County | Nueces | $490,000 | $547,225 | 1 |
| Eastland Memorial Hospital District | Eastland | $459,940 | $494,437 | 1 |
| West Hospital Authority | McLennan | $102,931 | $107,173 | 1 |
| Travis County Emergency SD 03 | Travis | $80,000 | $81,200 | 1 |
| Fannin County Hospital Authority | Fannin | $20,691 | $25,170 | 1 |
| Austin/Travis County MHMR Center | No issues | No issues | No issues | |
| Baylor Health Care System | Dallas | No issues | No issues | No issues |
| Bexar County MHMR | No issues | No issues | No issues | |
| Bluebonnet Trails Community MHMR Center | Williamson | No issues | No issues | No issues |
| Booker Hospital District | Lipscomb | No issues | No issues | No issues |
| Bowie Hospital Authority | Montague | No issues | No issues | No issues |
| Burleson County Hospital District | Burleson | No issues | No issues | No issues |
| Burnet County Hospital Authority | Burnet | No issues | No issues | No issues |
| Chambers County Public Hospital District 1 | Chambers | No issues | No issues | No issues |
| Dallas Metrocare Services (MHMR) | Dallas | No issues | No issues | No issues |
| Denton County MHMR Center | Denton | No issues | No issues | No issues |
| El Paso County 911 District | El Paso | No issues | No issues | No issues |
| Gulf Bend MHMR Center | Victoria | No issues | No issues | No issues |
| Gulf Coast Center (MHMR) The | Galveston | No issues | No issues | No issues |
| Hansford County Hospital District | Hansford | No issues | No issues | No issues |
| Hopkins County Hospital District | Hopkins | No issues | No issues | No issues |
| Lynn County Hospital District | Lynn | No issues | No issues | No issues |
| Matagorda County Hospital District | Matagorda | No issues | No issues | No issues |
| MHMR Services for the Concho Valley | Tom Green | No issues | No issues | No issues |
| Muleshoe Area Hospital District | Bailey, Parmer | No issues | No issues | No issues |
| Palo Pinto Hospital District | Palo Pinto | No issues | No issues | No issues |
| Sabine Valley MHMR Center | No issues | No issues | No issues | |
| South Limestone Hospital District | Limestone | No issues | No issues | No issues |
| Starr County Memorial Hospital District | Starr | No issues | No issues | No issues |
| Texoma Regional MHMR Center | No issues | No issues | No issues |
EMMA links are added as each issue is matched.
Source: Local Issuance Fee By Year (updated by the publisher 10/6/2026); Debt Outstanding By Issuance Local By Year (updated by the publisher 9/9/2026). Loaded here 10/18/2026.
Texas fiscal years run September 1 to August 31.
Issuer names are shown as published, without source footnote letters.
Figures are as reported to the agency and have not been independently verified.