Relating to the expansion of eligibility for Medicaid to certain individuals under the federal Patient Protection and Affordable Care Act.

HB 1423 would require Texas to expand Medicaid eligibility under the federal Affordable Care Act, providing coverage to all eligible applicants who qualify for federal matching funds. It directly affects low-income Texans who currently fall in the Medicaid coverage gap but meet federal ACA criteria. The bill mandates that the Health and Human Services Commission implement this expansion by January 1, 2026, contingent on voter approval of a related constitutional amendment. It also requires annual reports tracking impacts on uninsured rates, state/hospital costs, and charity care.