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 40 proposes a constitutional amendment requiring Texas to expand Medicaid eligibility to all individuals who apply and qualify under the federal Affordable Care Act (ACA), using available federal matching funds. This would directly affect low-income Texans who currently fall into a coverage gap under Texas Medicaid rules. The amendment would take effect January 1, 2026, but expire January 1, 2027, unless ratified by voters. It must be approved by Texas voters in the November 2025 election to become part of the state constitution. The proposal does not change existing Medicaid rules but mandates state action when federal funds are available.