Texas would provide Medicaid to people covered by federal matching funds

The Health and Human Services Commission would provide Medicaid assistance to every applicant for whom federal matching funds are available under the federal health law. The provision covers people applying for Medicaid assistance under Chapter 32 of the Texas Human Resources Code. Federal matching funds must be available for the assistance. If a federal waiver or authorization is needed, the agency may delay implementation until it is granted. The provision would take effect only if voters approve the specified constitutional amendment. The rule would apply to initial eligibility decisions and recertifications made on or after January 1, 2026, regardless of when the person applied.

The commission would send an annual report about the effects of the Medicaid eligibility provision to state leaders and the committees overseeing Medicaid. The report would cover uninsured people, state and local health care costs, and hospitals’ charity and unpaid care costs. The report would be due by December 1 each year.

The executive commissioner would take steps to carry out the Medicaid provision and notify federal agencies about the expanded eligibility. The duty applies to the Health and Human Services Commission and any state agency affected by implementation. An agency must request a federal waiver or authorization if it decides one is needed. The agency may delay implementation of the affected provision until federal approval is granted. The required implementation steps would begin as soon as possible after the Act’s effective date.