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 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 proposed by the 89th Legislature, which must be approved by voters. If the amendment is approved, the new eligibility criteria will apply to initial determinations or recertifications of medical assistance eligibility made on or after January 1, 2026. The bill emphasizes the need for state agencies to seek any necessary federal waivers or authorizations before implementing the provisions, ensuring compliance with federal requirements.

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