Texas last week signaled its defiance of the federal government over unproven stem cell therapies, which are widely offered in the state for conditions including joint damage, diabetes, and neurodegenerative illnesses. A bill signed by Governor Greg Abbott allows clinics and companies in the state to offer the experimental treatments without the testing and approval required under federal law, provided they are recommended and delivered by a physician, and performed at a hospital or medical center with oversight from an institutional review board. Now, bioethicists and patient advocates wonder whether the state’s official blessing will simply maintain the status quo, embolden clinics already profiting from potentially risky therapies, or—perhaps—tighten certain protections for patients.