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

HB 283 would require Texas to expand Medicaid eligibility to all low-income adults who qualify under the federal Affordable Care Act (ACA), starting January 1, 2026, if a related constitutional amendment passes. It mandates that Texas provide Medicaid coverage to all applicants meeting federal ACA criteria for which federal funds are available, without requiring state cost-sharing. The bill also requires an annual report to the legislature on how the expansion affects uninsured rates, state and local healthcare costs, and hospital charity care. This change would directly impact thousands of low-income Texans who currently lack Medicaid coverage but qualify under federal ACA guidelines. The effective date depends on voter approval of a 2025 constitutional amendment.