H.B. No. 1423 proposes an expansion of Medicaid eligibility in Texas, aligning with the federal Patient Protection and Affordable Care Act. The bill introduces a new Subchapter H to Chapter 32 of the Human Resources Code, which mandates that the Health and Human Services Commission provide medical assistance to all individuals who apply and qualify for federal matching funds under the Affordable Care Act. Additionally, the executive commissioner is tasked with adopting rules to facilitate this provision. An annual report is also required, detailing the impact of this expanded eligibility on various health care metrics, including the number of uninsured individuals and associated state and local health care costs.

The implementation of this expanded eligibility is contingent upon the approval of a constitutional amendment by Texas voters, which is set to be proposed during the 89th Legislature's Regular Session in 2025. If approved, the new eligibility criteria will take effect on January 1, 2026, but only if the necessary federal waivers or authorizations are obtained. If the amendment does not pass, the provisions of this bill will have no effect.

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