H.B. No. 891 proposes significant reforms to the Texas Medicaid program by introducing a block grant funding system and an alternative program designed to provide health benefit plan coverage to low-income individuals through private market solutions. The bill establishes Chapter 532A in the Government Code, detailing definitions, federal authorization requirements, and the administration of the state Medicaid program under this new framework. It mandates the creation of a risk-based Medicaid managed care model and specifies that acute care benefits will be provided to eligible individuals based on income thresholds and other criteria.

Additionally, the bill introduces Chapter 545A, which aims to connect low-income residents with health benefit plan coverage while clarifying that the program does not create an entitlement to assistance. The executive commissioner is responsible for implementing necessary rules, and the bill emphasizes the need for cost-neutral agreements that enhance health coverage options and improve healthcare service efficiency. It also establishes a Medicaid Reform Task Force to guide the program's design, includes provisions for customized benefits for home and community-based services, and mandates studies to improve the estate recovery program. The bill is set to take effect on September 1, 2025, pending federal authorizations.

Statutes affected:
Introduced: Subtitle I, Title , Government Code 1.01, Subtitle I, Title , Government Code 2.01, Subchapter B, Chapter , Human Resources Code 3.02 (Subtitle I, Title , Government Code 2, Subchapter B, Chapter , Human Resources Code 3, Subtitle I, Title , Government Code 1)