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

SB 45 would require Texas to expand Medicaid eligibility under the federal Affordable Care Act, providing coverage to all Texans who apply and qualify for federal matching funds. It directly affects low-income adults who currently lack Medicaid access but meet federal ACA criteria. Key provisions include mandating the state to provide this coverage, requiring annual reports on coverage rates and cost impacts (including hospital charity care), and setting an effective date of January 1, 2026 - conditional on voter approval of a related constitutional amendment. The bill does not create new funding but implements existing federal Medicaid expansion rules.