The bill, H.B. No. 726, proposes an expansion of Medicaid eligibility in Texas to include individuals who qualify for medical assistance under the federal Patient Protection and Affordable Care Act (ACA). It introduces a new Subchapter H to Chapter 32 of the Human Resources Code, which mandates that the commission provide medical assistance to all applicants eligible for federal matching funds under the ACA. Additionally, the executive commissioner is required to adopt rules for the implementation of this expanded eligibility. An annual report is also mandated, detailing the effects of this expansion on health coverage, state and local healthcare costs, and charity care.

The provisions of this bill will only apply to eligibility determinations made on or after January 1, 2026. The bill's effectiveness 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.

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