The bill, S.B. No. 637, 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 Texas Health and Human Services 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 to assess the impact of this expansion on various health care costs and the number of uninsured individuals in the state.

The provisions of this bill will take effect on January 1, 2026, contingent upon the approval of a constitutional amendment by Texas voters that requires the state to expand Medicaid eligibility as outlined. If the amendment is not approved, the bill will have no effect. The bill emphasizes the need for the Health and Human Services Commission to take necessary actions to implement the expansion, including seeking any required federal waivers or authorizations before proceeding.

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