Healthcare

HJR 34 proposes a constitutional amendment requiring Texas to expand Medicaid eligibility to all individuals who apply and qualify under federal matching funds provided by the Affordable Care Act. If approved by voters, the state would be obligated to cover these individuals starting January 1, 2026, using available federal funds. The amendment includes a temporary provision making it effective for one year (through January 1, 2027) and requires voter approval in the November 2025 election. This would directly affect low-income Texans currently excluded from Medicaid due to Texas's existing eligibility limits.

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.

HB 316 would expand Medicaid eligibility to certain low-income adults under the federal Affordable Care Act (ACA), specifically targeting individuals who currently fall above the state's existing income threshold but qualify under the ACA's expanded criteria. This change would directly affect working adults and families who earn too much for traditional Medicaid but still struggle to afford health insurance. The bill's key provision would update the state's eligibility rules to align with the ACA's expansion, allowing more residents to access covered health services. The bill was filed on September 3, 2025, and remains pending legislative review.

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.