The bill, H.B. No. 197, proposes an expansion of Medicaid eligibility in Texas to include all individuals who apply for medical assistance and for whom federal matching funds are available under the Patient Protection and Affordable Care Act (PPACA). This expansion is codified in a new Subchapter H of Chapter 32 of the Human Resources Code, specifically under Sections 32.351 and 32.352. Section 32.351 mandates that the Health and Human Services Commission provide medical assistance as long as federal funds are accessible, while Section 32.352 requires an annual report to state leaders on the impacts of this expanded eligibility, including effects on uninsured individuals and state healthcare costs.

The implementation of this bill is contingent upon the approval of a constitutional amendment proposed by the 89th Legislature in 2025, which would require the state to expand Medicaid eligibility as outlined. If the amendment is approved, the provisions of this bill will take effect on January 1, 2026. However, if the amendment is not approved by voters, the bill will have no effect. The executive commissioner of the Health and Human Services Commission is tasked with taking necessary actions to implement this expansion, including seeking any required federal waivers or authorizations.

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