H.B. No. 1903 proposes significant reforms to the Medicaid program in Texas by introducing a block grant funding system and establishing a new program to provide health benefit plan coverage to low-income individuals through private market solutions. The bill amends the Government Code by adding Chapter 532A, which defines the reformed state Medicaid program operating under a risk-based managed care model, outlines eligibility criteria for Medicaid acute care benefits, and introduces sliding scale subsidies and health savings accounts for eligible individuals. Additionally, Chapter 545A is introduced to ensure health benefit coverage through private market solutions, emphasizing that the program does not create an entitlement to assistance and requires negotiations with federal authorities for necessary waivers.

The bill aims to create a cost-neutral health benefit program that provides efficient coverage options while relieving local tax burdens and reducing reliance on general revenue. It defines eligibility for individuals aged 64 or younger with household incomes at or below 133% of the federal poverty level, who are not otherwise eligible for Medicaid. The program will offer premium assistance for private health coverage, promote personal responsibility, and include pay-for-performance initiatives for health plan issuers. The Health and Human Services Commission is responsible for developing a proposal for federal authorization, with the program set to take effect on September 1, 2025, pending necessary federal approvals.

Statutes affected:
Introduced: Subtitle I, Title , Government Code 1.01, Subtitle I, Title , Government Code 2.01 (Subtitle I, Title , Government Code 1, Subtitle I, Title , Government Code 2)