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 21 proposes a constitutional amendment requiring Texas to expand Medicaid eligibility to all individuals who apply for Medicaid and meet federal eligibility criteria under the Affordable Care Act (ACA), using available federal matching funds. It would mandate the state to provide medical assistance to these applicants, directly affecting low-income Texans who currently lack Medicaid coverage due to Texas' existing eligibility limits. The amendment would take effect January 1, 2026, if approved by voters in November 2025, with a temporary provision expiring January 1, 2027. This change would implement the ACA's Medicaid expansion without altering federal eligibility standards.