H.B. No. 283 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 expanded eligibility. An annual report is also required, detailing the effects of this expansion on health coverage, state and local healthcare costs, and charity care.

The provisions of this bill will only apply to initial determinations or recertifications of eligibility made on or after January 1, 2026. The implementation of the bill is contingent upon the approval of a constitutional amendment proposed by the 89th Legislature, which must be approved by voters. If the amendment is not approved, the bill will have no effect.

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