HB 26: Medicaid plans may swap in nutrition counseling for services

Caption

relating to requiring contracts with Medicaid managed care organizations to permit the organizations to offer nutrition counseling and instruction services in lieu of other state Medicaid plan services.

Caption from analyzed text · version I.

Summary

Before, only mental health or substance use services qualified.

The bill requires state contracts with Medicaid managed care companies to let those companies offer nutrition counseling and instruction in place of other Medicaid plan services, not just mental health or substance use services as current law allows. It touches Medicaid managed care organizations, Medicaid recipients, the state Medicaid managed care advisory committee that approves the list, and the Health and Human Services Commission. On the ground, plans can swap in approved nutrition counseling for other covered services, recipients can still choose the original service, and the list may not include home-delivered meals, food prescriptions or grocery support.

Labels

Labels: ACROSS THE AISLE. Joint authors: 3 Republicans, 2 Democrats. Party as the Legislative Reference Library lists it for the 89th Legislature.

Receipt

The receipt

89R-HB26 · 2025-03-05

SOLD BY

Rep. Lacey HullRHouse 138

Rep. Toni RoseDHouse 110

Rep. Carrie IsaacRHouse 73

+ 2 more authors, 6 coauthors

ITEM

relating to requiring contracts with Medicaid managed care organizations to permit the organizations to offer nutrition counseling and instruction services in lieu of other state Medicaid plan services.

WHAT IT DOES

Before, only mental health or substance use services qualified.

The bill requires state contracts with Medicaid managed care companies to let those companies offer nutrition counseling and instruction in place of other Medicaid plan services, not just mental health or substance use services as current law allows. It touches Medicaid managed care organizations, Medicaid recipients, the state Medicaid managed care advisory committee that approves the list, and the Health and Human Services Commission. On the ground, plans can swap in approved nutrition counseling for other covered services, recipients can still choose the original service, and the list may not include home-delivered meals, food prescriptions or grocery support.

CHARGES

[ ] NONE FOUND

TOTAL

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version F · source

Sources

Fiscal note · version F · May 28, 2025

No first-year general revenue figure available here.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

HISTORY

Mar 5, 2025Filed
Mar 6, 2025Read first time
Mar 6, 2025Referred to Human Services
Mar 11, 2025Scheduled for public hearing on . . .
Mar 11, 2025Considered in public hearing
Mar 11, 2025Testimony taken/registration(s) recorded in committee
Mar 11, 2025Left pending in committee
Mar 25, 2025Considered in public hearing
Mar 25, 2025Reported favorably w/o amendment(s)
Mar 31, 2025Comte report filed with Committee Coordinator
Mar 31, 2025Committee report distributed
Mar 31, 2025Committee report sent to Calendars
Apr 17, 2025Considered in Calendars
Apr 22, 2025Placed on General State Calendar
Apr 22, 2025Read 2nd time
Apr 22, 2025Amended 1-Hull and Oliverson
Apr 22, 2025Record vote RV#319
Apr 22, 2025Passed to engrossment as amended
Apr 22, 2025Record vote RV#320
Apr 23, 2025Read 3rd time
Apr 23, 2025Passed
Apr 23, 2025Record vote RV#374
Apr 23, 2025Statement(s) of vote recorded in Journal
Apr 23, 2025Reported engrossed
Apr 23, 2025Received from the House
Apr 28, 2025Read first time
Apr 28, 2025Referred to Health & Human Services
Apr 30, 2025Co-sponsor authorized
May 5, 2025Considered in public hearing
May 5, 2025Vote taken in committee
May 7, 2025Reported favorably as substituted
May 7, 2025Recommended for local & uncontested calendar
May 7, 2025Committee report printed and distributed
May 9, 2025Placed on intent calendar
May 20, 2025Not again placed on intent calendar
May 25, 2025Placed on intent calendar
May 26, 2025Rules suspended-Regular order of business
May 26, 2025Read 2nd time
May 26, 2025Amendment(s) offered FA1 Kolkhorst
May 26, 2025Amended
May 26, 2025Vote recorded in Journal
May 26, 2025Amendment(s) offered FA2 Johnson
May 26, 2025Amendment withdrawn
May 26, 2025Passed to 3rd reading as amended
May 26, 2025Vote recorded in Journal
May 26, 2025Three day rule suspended
May 26, 2025Record vote
May 26, 2025Read 3rd time
May 26, 2025Passed
May 26, 2025Record vote
May 26, 2025Senate passage as amended reported
May 28, 2025Senate Amendments distributed
May 28, 2025Senate Amendments Analysis distributed
May 29, 2025House concurs in Senate amendment(s)
May 29, 2025Record vote RV#4024
May 29, 2025Statement(s) of vote recorded in Journal
May 29, 2025Text of Senate Amendment(s)
May 29, 2025House concurs in Senate amendment(s)-reported
May 30, 2025Reported enrolled
May 31, 2025Signed in the House
Jun 1, 2025Signed in the Senate
Jun 1, 2025Sent to the Governor
Jun 20, 2025Signed by the Governor
Jun 20, 2025Effective on 9/1/25

FILED UNDER

No verified beat found.

SIGNED FOR BY

House · 132 yea · 13 nay

Senate · 30 yea · 1 nay

Sources

House: Final passage · Apr 23, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

Senate: Final passage · May 26, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

All floor motions and other positions below.

No flags

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

Lacey Hull

Donors

Texans for Lawsuit Reform PAC$595K Texas Conservative Majority PAC$483K Texas Sands PAC$245K

Not tied to this bill.

Sources

The author's campaign account only. Own money and internal transfers are separate on the member page.

Derived itemized flow · Oct 28, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Texans for Lawsuit Reform PAC$595,376.10

Texans for Lawsuit Reform PAC

$595,376.10

Cash: $80,000.00
Paid by others: $515,376.10
Total: $595,376.10

mail $216,305.25advertising $185,974.50Other filed descriptions $66,286.00polling $46,810.35

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Jun 30, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101010359, 101033114, 101035066, 101040912, 101044098, 101069436, 101072848.

Texas Conservative Majority PAC$483,456.00

Texas Conservative Majority PAC

$483,456.00

Cash: $150,000.00
Paid by others: $333,456.00
Total: $483,456.00

canvassing $316,956.00polling $16,500.00

Also funds 42 other sitting lawmakers.

Derived recipient stock · Jan 23, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Feb 13, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101040912, 101069436, 101072848.

Texas Sands PAC$244,600.00

Texas Sands PAC

$244,600.00

Cash: $234,000.00
Paid by others: $10,600.00
Total: $244,600.00

polling $10,600.00

Also funds 121 other sitting lawmakers.

Derived recipient stock · Jul 3, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Jan 14, 2026 to Sep 25, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101035066, 101040912, 101072848.

Money

Missing data does not establish zero giving. Display amounts are rounded.

×

Texans for Lawsuit Reform PAC

$595,376.10

Cash: $80,000.00
Paid by others: $515,376.10
Total: $595,376.10

mail $216,305.25advertising $185,974.50Other filed descriptions $66,286.00polling $46,810.35

Also funds 124 other sitting lawmakers.

Derived recipient stock · Jul 10, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Jun 30, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101010359, 101033114, 101035066, 101040912, 101044098, 101069436, 101072848.

×

Texas Conservative Majority PAC

$483,456.00

Cash: $150,000.00
Paid by others: $333,456.00
Total: $483,456.00

canvassing $316,956.00polling $16,500.00

Also funds 42 other sitting lawmakers.

Derived recipient stock · Jan 23, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Feb 13, 2026 to Oct 23, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101040912, 101069436, 101072848.

×

Texas Sands PAC

$244,600.00

Cash: $234,000.00
Paid by others: $10,600.00
Total: $244,600.00

polling $10,600.00

Also funds 121 other sitting lawmakers.

Derived recipient stock · Jul 3, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

TEC account match.

Team

Sources

Derived itemized flow · Jan 14, 2026 to Sep 25, 2026. State data as of Nov 4, 2026.

Derived itemized contributions on live regular reports and uncovered special-session dates. Internal account transfers and daily reports are excluded.

Report IDs: 101035066, 101040912, 101072848.

Votes7

House May 29, 2025

Yea: 130
Nay: 9
Present, not voting: 1
Absent: 5
Excused: 5

Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 4024

Representative Hull moved to concur in the senate amendments to HB 26. The motion to concur in the senate amendments to HB 26 prevailed by (Record 4024): 130 Yeas, 9 Nays, 1 Present, not voting.

Published stock of positions for this vote, except where marked derived.

Yea: 130 (published)
Nay: 9 (published)
Present, not voting: 1 (published)
Absent: 5 (derived from named list)
Excused: 5 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

Senate May 26, 2025

Yea: 30
Nay: 1
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Names

HagenbuchNay

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Names were not printed for yea. Only the named positions are included in member records.

Sources

The bill was read third time and was passed by the following vote: Yeas 30, Nays 1. (Same as previous roll call)

Published stock of positions for this vote, except where marked derived.

Yea: 30 (published)
Nay: 1 (published)
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 26, 2025

Yea: 30
Nay: 1
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Names

HagenbuchNay

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Names were not printed for yea. Only the named positions are included in member records.

Sources

Senator Kolkhorst moved that Senate Rule 7.18 and the Constitutional Rule requiring bills to be read on three several days be suspended and that CSHB 26 be placed on its third reading and final passage. The motion prevailed by the following vote: Yeas 30, Nays 1.

Published stock of positions for this vote, except where marked derived.

Yea: 30 (published)
Nay: 1 (published)
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Senate journal. Source snapshot 2026-10-19, Central time.

Senate May 26, 2025

Yea: Not printed
Nay: Not printed
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Names

HagenbuchNay

Named positions matched to lawmakers. See the journal for unmatched names.

Senate journal

Names were not printed for yea. Only the named positions are included in member records.

Voice vote. No numeric tally or individual yeas are inferred.

Sources

CSHB 26 as amended was passed to third reading by a viva voce vote.

Published stock of positions for this vote, except where marked derived.

Yea: Not printed
Nay: Not printed
Present, not voting: Not printed
Absent: Not printed
Excused: Not printed

Senate journal. Source snapshot 2026-10-19, Central time.

House Apr 23, 2025

Yea: 132
Nay: 13
Present, not voting: 1
Absent: 4
Excused: 0

Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 374

HB 26 was passed by (Record 374): 132 Yeas, 13 Nays, 1 Present, not voting.

Published stock of positions for this vote, except where marked derived.

Yea: 132 (published)
Nay: 13 (published)
Present, not voting: 1 (published)
Absent: 4 (derived from named list)
Excused: 0 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

House Apr 22, 2025

Yea: 138
Nay: 9
Present, not voting: 2
Absent: 0
Excused: 1

Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 320

HB 26, as amended, was passed to engrossment by (Record 320): 138 Yeas, 9 Nays, 2 Present, not voting.

Published stock of positions for this vote, except where marked derived.

Yea: 138 (published)
Nay: 9 (published)
Present, not voting: 2 (published)
Absent: 0 (derived from named list)
Excused: 1 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

House Apr 22, 2025

Yea: 139
Nay: 8
Present, not voting: 1
Absent: 1
Excused: 1

Names

Named positions matched to lawmakers. See the journal for unmatched names.

House journal

Sources

Record 319

Amendment No. 1 was adopted by (Record 319): 139 Yeas, 8 Nays, 1 Present, not voting.

Published stock of positions for this vote, except where marked derived.

Yea: 139 (published)
Nay: 8 (published)
Present, not voting: 1 (published)
Absent: 1 (derived from named list)
Excused: 1 (derived from named list)

House journal. Source snapshot 2026-10-19, Central time.

Witnesses18

For: 15
Against: 0
On: 3

Names

For

Baylor Scott and White Health1 registration
Buckner International1 registration
Driscoll Health System1 registration
End Chronic Disease1 registration
Episcopal Health Foundation1 registration
Make Texans Healthy Again1 registration
Methodist Healthcare Ministries1 registration
Self; Texas Academy of Nutrition and Dietetics1 registration
Self; Texas Pediatric Society, Texas Medical Association1 registration
Texans Care for Children1 registration
Texas Association of Community Health Centers1 registration
Texas Association of Health Plans1 registration
Texas CASA1 registration
Texas Medical Association1 registration
Texas Women’s Healthcare Coalition1 registration

On

Health & Services Commissioner1 registration
Health and Human Services Commission1 registration
Houston Food Bank1 registration

Sources

18 parsed registrations across the loaded witness lists.

Derived stock of witness registrations. Repeated appearances count separately. Organizations and self-representation appear as printed.

House witness list. Source snapshot 2026-10-20, Central time.

Fiscal

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version F · source

Sources

Fiscal note · version F · May 28, 2025

No first-year general revenue figure available here.

LBB published estimates · flow over the stated periods.

Source snapshot 2026-10-19, Central time.

How this was graded

Analysis of text version I by claude-opus-5-5, Oct 20, 2026, against the published rubric.

Sources

Texas House · Filed Mar 5, 2025

06/20/2025 E Effective on 9/1/25

Texas Legislature Online · Introduced · House Committee Report · Engrossed · Senate Committee Report · Enrolled

Data snapshot Oct 26, 2026 at 4:20 AM CDT. Grades, charges, quotes and corrections follow the published record.

Coauthors

Aicha DavisDHouse 109

Lulu FloresDHouse 51

Jolanda "Jo" JonesDHouse 147

Suleman LalaniDHouse 76

Mihaela PlesaDHouse 70

Joanne ShofnerRHouse 11

Companion

SB 3001 by Kolkhorst (identical)

Subjects

Human Services--Medical Assistance

Mental Health & Substance Abuse

MEDICAID

NUTRITION

PREGNANCY & CHILDBIRTH

HEALTH & HUMAN SERVICES COMMISSION

Text

The text as introduced · 457 words

89R14146 SCF-D

By: Hull
H.B. No. 26

A BILL TO BE ENTITLED

AN ACT

relating to requiring contracts with Medicaid managed care

organizations to permit the organizations to offer nutrition

counseling and instruction services in lieu of other state Medicaid

plan services.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 540.0272, Government Code, as effective

April 1, 2025, is amended to read as follows:

Sec. 540.0272. CERTAIN SERVICES PERMITTED IN LIEU OF STATE

MEDICAID PLAN SERVICES [ OTHER MENTAL HEALTH OR SUBSTANCE USE

DISORDER SERVICES ]; ANNUAL REPORT. (a) A contract to which this

subchapter applies must contain language permitting the

contracting Medicaid managed care organization to offer medically

appropriate, cost-effective, evidence-based mental health or

substance use services or nutrition counseling and instruction

services from a list of services approved by the state Medicaid

managed care advisory committee and included in the contract in

lieu of [ mental health or substance use disorder ] services

specified in the state Medicaid plan. A recipient is not required

to use a service from the list included in the contract in lieu of

another [ mental health or substance use disorder ] service specified

in the state Medicaid plan.

(b) The commission shall:

(1) prepare and submit to the legislature an annual

report on the number of times during the preceding year a service

from the list included in the contract is used; and

(2) consider the actual cost and use of any services

from the list included in the contract that are offered by a

Medicaid managed care organization when setting the capitation

rates for that organization under the contract.

(c) In approving the list of nutrition counseling and

instruction services that are permitted in lieu of services

specified in the state Medicaid plan under this section, the state

Medicaid managed care advisory committee may only include nutrition

counseling and instruction. The list may not include:

(1) home-delivered meals;

(2) food prescriptions; or

(3) grocery support.

SECTION 2. The changes in law made by this Act apply to a

contract entered into or renewed on or after the effective date of

this Act. A contract entered into or renewed before that date is

governed by the law in effect on the date the contract was entered

into or renewed, and that law is continued in effect for that

purpose.

SECTION 3. If before implementing any provision of this Act

a state agency determines that a waiver or authorization from a

federal agency is necessary for implementation of that provision,

the agency affected by the provision shall request the waiver or

authorization and may delay implementing that provision until the

waiver or authorization is granted.

SECTION 4. This Act takes effect September 1, 2025.

Verdict: No flags

The receipt

SOLD BY

ITEM

WHAT IT DOES

CHARGES

TOTAL

HISTORY

SIGNED FOR BY

Donors

Texans for Lawsuit Reform PAC

Texas Conservative Majority PAC

Texas Sands PAC

Texans for Lawsuit Reform PAC

Texas Conservative Majority PAC

Texas Sands PAC

House May 29, 2025

Senate May 26, 2025

Senate May 26, 2025

Senate May 26, 2025

House Apr 23, 2025

House Apr 22, 2025

House Apr 22, 2025

For

On

Companion