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 (ACA). This expansion is codified in a new Subchapter H of Chapter 32 of the Human Resources Code, specifically under Section 32.351, which mandates the Health and Human Services Commission to provide medical assistance accordingly. Additionally, the executive commissioner is required to adopt rules for the implementation of this expanded eligibility.

Furthermore, the bill establishes an annual reporting requirement under Section 32.352, where the commission must report to key state officials on the impacts of the expanded eligibility, including effects on uninsured individuals, state and local healthcare costs, and charity care expenses. The provisions of this act will only apply to eligibility determinations made on or after January 1, 2026, contingent upon the approval of a related constitutional amendment by voters in the 2025 election. If the amendment is not approved, the act will have no effect.

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