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 69 proposes a constitutional amendment requiring Texas to expand Medicaid eligibility to all low-income individuals who qualify under federal Affordable Care Act rules (specifically, those for whom federal matching funds are available). This would directly affect uninsured Texans who currently fall into a Medicaid coverage gap under Texas law. The amendment would mandate state provision of medical assistance when federal funds are available, aligning Texas with the federal ACA framework. The proposal must be approved by voters in November 2025 and would take effect January 1, 2026, pending voter approval.