H.B. No. 2627 proposes the establishment of the Live Well Texas program, which aims to expand Medicaid eligibility and provide health benefit coverage to certain individuals. The bill introduces new chapters to the Government Code, specifically Chapters 532A and 532B, detailing the program's definitions, objectives, and administrative structure. Key features include the creation of health benefit plans (basic and plus plans), the establishment of Personal Wellness and Responsibility (POWER) accounts for participants, and a requirement for the executive commissioner to seek a federal waiver to implement the program under the state Medicaid plan. The program is designed to enhance access to healthcare for underserved populations while promoting personal responsibility and improving health outcomes.

The bill outlines eligibility criteria for enrollment, including residency, age, and the availability of federal matching funds, and mandates a consolidated application process. It specifies coverage requirements for health plans, including essential health benefits, and introduces provisions for pregnant participants, ensuring they receive comprehensive care without cost-sharing until two months post-pregnancy. Additionally, the bill establishes penalties for participants who fail to make required contributions to their health benefit plans and creates a "Gateway to Work" program to assist unemployed participants. If the waiver for the Live Well Texas program is approved, Medicaid benefits will transition to the new program, with the executive commissioner responsible for implementing the provisions, which will take effect immediately upon a two-thirds vote or on September 1, 2025, if that vote is not achieved.

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