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 to eligible individuals, while Section 32.352 requires an annual report on the effects of this expanded eligibility, including impacts on uninsured individuals, state and local healthcare costs, and charity care expenses.

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 not approved by voters, the bill will have no effect. The provisions of the bill will apply to initial determinations or recertifications of eligibility made on or after January 1, 2026. The executive commissioner of the Health and Human Services Commission is tasked with taking necessary actions to implement this expansion, including notifying federal agencies as needed.

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