H.B. No. 72 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 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 effects of this expanded eligibility on various aspects, including the number of uninsured individuals, state and local healthcare costs, and charity care expenses.

The implementation of this expanded eligibility is contingent upon the approval of a constitutional amendment proposed by the 89th Legislature, which must be approved by voters. If approved, the new eligibility criteria will apply to initial determinations or recertifications made on or after January 1, 2026. The bill emphasizes that the executive commissioner must take necessary actions to notify federal agencies and seek any required waivers before the provisions can be fully implemented. If the proposed amendment is not approved, the bill will have no effect.

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