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

HB 2604 would require Texas to expand Medicaid eligibility to all low-income Texans who qualify under the federal Affordable Care Act, using available federal matching funds. It directly affects individuals with incomes up to 138% of the federal poverty level who currently lack Medicaid coverage. The bill mandates the state to provide medical assistance to all eligible applicants and requires annual reports starting in 2026 on how the expansion impacts coverage rates, state/local health costs, and hospital charity care. The policy change takes effect January 1, 2026, contingent on a related constitutional amendment.