Proposing a constitutional amendment requiring the state to expand eligibility for Medicaid to certain individuals under the federal Patient Protection and Affordable Care Act.

HJR 131 proposes a constitutional amendment requiring Texas to expand Medicaid eligibility to all individuals who apply and qualify under federal standards set by the Affordable Care Act (ACA), including those currently excluded due to Texas' existing income limits. If passed, it would mandate the state to accept federal Medicaid matching funds to cover these individuals, directly affecting hundreds of thousands of low-income Texans who currently lack coverage. The amendment would take effect January 1, 2026, pending voter approval in the November 2025 election. This would legally bind Texas to implement the ACA's Medicaid expansion, which the state has not adopted since the law's passage.