Garland’s experiment with tacking a telehealth fee onto residents’ utility bills is over. Interim City Manager Mike Betz quietly pulled the plug on the city’s agreement with MD Health Pathways and scrapped a planned May 2 special election, signing the termination on Feb. 17, before any households were enrolled or billed. The decision ends a months-long fight over whether an opt-out billing scheme was an acceptable way to expand basic health care access for uninsured and underinsured residents.
According to the City of Garland, Betz used Section 6.1 of the master agreement to end the Tap Telehealth contract, and the council the same night declared the May proposition moot. The council had originally signed off on the deal on Aug. 19, 2025, by a 7-2 vote, per Citizen Portal. City materials described automatic enrollment through utility bills at about $6 a month, and that opt-out structure ignited fierce public comment and drew sustained media scrutiny.
How the plan would have worked
MD Health Pathways marketed Tap Telehealth as a utility-bill line item that residents would be added to unless they actively opted out. The service would have connected people to clinicians by text, phone or video for non-emergency needs. The company’s own materials lay out a community subscription model and reference a $9-a-month opt-out line item, according to MD Health Pathways. Supporters said broad enrollment was the only way to cut down on unnecessary 911 calls and emergency room visits and to reach the scale needed to make any real dent in local health access problems.
Community pushback and pilot numbers
Before the full rollout, MD Health Pathways ran a free pilot program for roughly 10,000 Garland households and said it mailed information to about 82,000 addresses, according to KERA. Subsequent reporting found the pilot generated relatively modest use, with “fewer than 3,000” total interactions, and that nearly 6,000 households opted out in the weeks after the council vote, Dallas Observer reported. MD Health Pathways CEO Dirk Perritt told KERA that the numbers tell a different story than the noise coming from council chambers, arguing the pilot data showed the model was working even as political opposition grew louder.
Why officials pulled the plug
City leaders said the reversal came after months of public feedback and legal review, and that the contract’s termination language allowed Garland to walk away without paying a penalty. Editorial writers at The Dallas Morning News backed the move to pause, arguing the opt-out utility billing looked too much like a hidden city fee and risked confusing seniors and residents who do not speak English as a first language. Critics also questioned whether a municipal utility bill is the right place to finance what is essentially a subscription health service.
What’s next for Garland
The council later approved an ordinance formally canceling the May special election and declaring the proposition moot. The text notes that the underlying contract had already been terminated and that no similar vendor was available to provide the service at the same price point. See the official record from the City of Garland. Local coverage estimated the off-cycle election would have cost the city about $300,000, a budget hit officials said they weighed as they moved to stop the vote and the rollout.
With the municipal pilot shelved, Garland is still staring at a gap in local access to routine care. Any replacement plan is likely to lean harder on clear consent and more aggressive outreach, and future proposals will be judged against the transparency and affordability concerns that defined this fight.
