Relating to the expansion of eligibility for Medicaid to all individuals for whom federal matching money is available.

SB 657 would require Texas to seek a federal waiver to expand Medicaid eligibility to all individuals who qualify for federal matching funds under existing Medicaid programs. The bill mandates that the waiver must aim to reduce the number of uninsured residents, promote health care responsibility, improve service efficiency and accessibility, and lower health care costs. Texas would apply for this waiver through the federal Centers for Medicare and Medicaid Services, with implementation delayed until the waiver is approved. The bill takes effect immediately if passed with a two-thirds vote, or on September 1, 2025, otherwise. This is a procedural step to potentially expand Medicaid coverage, not an immediate policy change.