Monitoring the Session

HB 5155

Medicaid Opioid Pilot Continues Only If Lawmakers Pay For It

Became law, effective Sep 1, 2025

Verdict: Smells

SmellsNeeds review
Rep. Toni RoseDHouse 110
Why it's charged
The hole

THE TEXT

“The Health and Human Services Commission is required to implement a provision of this Act only if the legislature appropriates money specifically for that purpose.”

Bill text, introduced version (I)

The bill says the commission "shall continue" the pilot, but this clause and the "to the extent funds are available" opener turn that duty into an option if no money is set aside. That makes continuation depend on a separate funding decision.

The hole

Needs review · Nov 1, 2026 · Headline, summary and grade are analysis of the bill text, not a finding about any person · How we grade

Caption

relating to the continuation of a pilot program designed to improve the quality and accessibility of care for certain Medicaid recipients.

Caption from analyzed text · version I.

Summary

No appropriation, no duty. Runs to December 1, 2028, if the money is there.

The bill tells the state health commission to keep running the Maternal Opioid Misuse Model pilot program, which serves pregnant women on Medicaid with opioid use disorder and their babies, until the program expires on December 1, 2028. It also tells the Texas opioid abatement fund council to put that program at the front of the line for grants from the Opioid Abatement Trust Fund, and it requires a report to the Legislature on birth outcomes by December 31, 2028. On the ground, the program continues only if money is there, because the commission does not have to act unless the Legislature sets aside funds specifically for it.

Labels

Labels: CROSS-PARTY HANDOFF. Lead author Toni Rose (D) in the House. Lead sponsor Lois Kolkhorst (R) in the Senate. Party as the Legislative Reference Library lists it for the 89th Legislature.

Receipt

The receipt

89R-HB5155 · 2025-03-14

SOLD BY

ITEM

relating to the continuation of a pilot program designed to improve the quality and accessibility of care for certain Medicaid recipients.

WHAT IT DOES

No appropriation, no duty. Runs to December 1, 2028, if the money is there.

The bill tells the state health commission to keep running the Maternal Opioid Misuse Model pilot program, which serves pregnant women on Medicaid with opioid use disorder and their babies, until the program expires on December 1, 2028. It also tells the Texas opioid abatement fund council to put that program at the front of the line for grants from the Opioid Abatement Trust Fund, and it requires a report to the Legislature on birth outcomes by December 31, 2028. On the ground, the program continues only if money is there, because the commission does not have to act unless the Legislature sets aside funds specifically for it.

CHARGES

[x] THE HOLEanalysis confidence 45%

THE TEXT

“The Health and Human Services Commission is required to implement a provision of this Act only if the legislature appropriates money specifically for that purpose.”

Bill text, introduced version (I)

The bill says the commission "shall continue" the pilot, but this clause and the "to the extent funds are available" opener turn that duty into an option if no money is set aside. That makes continuation depend on a separate funding decision.

TOTAL

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version E · source

Sources

Fiscal note · version E · May 19, 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

  1. Filed
  2. Read first time
  3. Referred to Human Services
  4. Scheduled for public hearing on . . .
  5. Considered in public hearing
  6. Committee substitute considered in committee
  7. Testimony taken/registration(s) recorded in committee
  8. Left pending in committee
  9. Considered in formal meeting
  10. Committee substitute considered in committee
  11. Reported favorably as substituted
  12. Comte report filed with Committee Coordinator
  13. Committee report distributed
  14. Committee report sent to Calendars
  15. Considered in Calendars
  16. Placed on General State Calendar
  17. Read 2nd time
  18. Passed to engrossment
  19. Record vote RV#1701
  20. Statement(s) of vote recorded in Journal
  21. Read 3rd time
  22. Passed
  23. Record vote RV#1810
  24. Reported engrossed
  25. Received from the House
  26. Read first time
  27. Referred to Health & Human Services
  28. Scheduled for public hearing on . . .
  29. Considered in public hearing
  30. Left pending in committee
  31. Considered in public hearing
  32. Recommended for local & uncontested calendar
  33. Vote taken in committee
  34. Reported favorably w/o amendments
  35. Committee report printed and distributed
  36. Placed on local & uncontested calendar
  37. Laid before the Senate
  38. Read 2nd time & passed to 3rd reading
  39. Vote recorded in Journal
  40. Three day rule suspended
  41. Record vote
  42. Read 3rd time
  43. Passed
  44. Record vote
  45. Senate passage reported
  46. Reported enrolled
  47. Signed in the House
  48. Signed in the Senate
  49. Sent to the Governor
  50. Signed by the Governor
  51. Effective on 9/1/25
FILED UNDER

No verified beat found.

SIGNED FOR BY

House · 143 yea · 1 nay

Senate · 31 yea · 0 nay

Sources

House: Final passage · May 8, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

Senate: Final passage · May 25, 2025. Journal. Published stock for this vote. Snapshot 2026-10-19, Central time.

All floor motions and other positions below.

Smells

THANK YOU FOR CHECKING THE RECEIPT

CAMPAIGN PAID FOR BY

CAMPAIGN PAID FOR BY

Donors

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 · Jul 12, 2024 to Jun 27, 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.

Texas Trial Lawyers Association PAC$22,500.00

Texas Trial Lawyers Association PAC

$22,500.00

Cash
$22,500.00
Paid by others
$0.00
Total
$22,500.00

Also funds 137 other sitting lawmakers.

Derived recipient stock · Jul 24, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Oct 15, 2024 to Jun 22, 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: 100989331, 101032423, 101061700.

Texas Sands PAC$14,000.00

Texas Sands PAC

$14,000.00

Cash
$14,000.00
Paid by others
$0.00
Total
$14,000.00

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 · Sep 24, 2024 to May 18, 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: 100989331, 101061700.

Texans for Truth and Liberty PAC$10,000.00

Texans for Truth and Liberty PAC

$10,000.00

Cash
$10,000.00
Paid by others
$0.00
Total
$10,000.00

Also funds 44 other sitting lawmakers.

Derived recipient stock · Jun 24, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · on Jun 24, 2025. 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: 101010994.

Money

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

×

Texas Trial Lawyers Association PAC

$22,500.00

Cash
$22,500.00
Paid by others
$0.00
Total
$22,500.00

Also funds 137 other sitting lawmakers.

Derived recipient stock · Jul 24, 2024 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Oct 15, 2024 to Jun 22, 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: 100989331, 101032423, 101061700.

×

Texas Sands PAC

$14,000.00

Cash
$14,000.00
Paid by others
$0.00
Total
$14,000.00

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 · Sep 24, 2024 to May 18, 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: 100989331, 101061700.

×

Texans for Truth and Liberty PAC

$10,000.00

Cash
$10,000.00
Paid by others
$0.00
Total
$10,000.00

Also funds 44 other sitting lawmakers.

Derived recipient stock · Jun 24, 2025 to Oct 23, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · on Jun 24, 2025. 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: 101010994.

Votes5

Senate May 25, 2025

Final passage

Yea
31
Nay
0
Present, not voting
Not printed
Absent
Not printed
Excused
Not printed
Names

Senate journal

Names were not printed. No individual positions are inferred.

The journal row lists three votes in order: passage to third reading, suspension of the three-day rule, and final passage. This entry records final passage. Repeated tallies belong to separate votes.

Sources

HB 5155 (Kolkhorst) Relating to the continuation of the maternal opioid misuse model of care for certain Medicaid recipients. (viva voce vote) (31-0) (31-0)

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

  • Yea: 31 (published)
  • Nay: 0 (published)
  • Present, not voting: Not printed
  • Absent: Not printed
  • Excused: Not printed

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

Senate May 25, 2025

Suspension of the three-day rule

Yea
31
Nay
0
Present, not voting
Not printed
Absent
Not printed
Excused
Not printed
Names

Senate journal

Names were not printed. No individual positions are inferred.

The journal row lists three votes in order: passage to third reading, suspension of the three-day rule, and final passage. This entry records suspension of the three-day rule. Repeated tallies belong to separate votes.

Sources

HB 5155 (Kolkhorst) Relating to the continuation of the maternal opioid misuse model of care for certain Medicaid recipients. (viva voce vote) (31-0) (31-0)

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

  • Yea: 31 (published)
  • Nay: 0 (published)
  • Present, not voting: Not printed
  • Absent: Not printed
  • Excused: Not printed

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

Senate May 25, 2025

Passage to third reading

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

Senate journal

Names were not printed. No individual positions are inferred.

The journal row lists three votes in order: passage to third reading, suspension of the three-day rule, and final passage. This entry records passage to third reading. Repeated tallies belong to separate votes.

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

Sources

HB 5155 (Kolkhorst) Relating to the continuation of the maternal opioid misuse model of care for certain Medicaid recipients. (viva voce vote) (31-0) (31-0)

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 May 8, 2025

Yea
143
Nay
1
Present, not voting
2
Absent
2
Excused
2
Names

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

House journal

Sources

Record 1810

HB 5155 was passed by (Record 1810): 143 Yeas, 1 Nays, 2 Present, not voting.

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

  • Yea: 143 (published)
  • Nay: 1 (published)
  • Present, not voting: 2 (published)
  • Absent: 2 (derived from named list)
  • Excused: 2 (derived from named list)

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

House May 7, 2025

Yea
140
Nay
3
Present, not voting
1
Absent
3
Excused
3
Names

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

House journal

Sources

Record 1701

CSHB 5155 was passed to engrossment by (Record 1701): 140 Yeas, 3 Nays, 1 Present, not voting.

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

  • Yea: 140 (published)
  • Nay: 3 (published)
  • Present, not voting: 1 (published)
  • Absent: 3 (derived from named list)
  • Excused: 3 (derived from named list)

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

Witnesses27
For
24
Against
0
On
3
Names

For

  • Bexar County Commissioners Court1 registration
  • Dallas County1 registration
  • Harris County Commissioners Court1 registration
  • Methodist Healthcare Ministries2 registrations
  • NAMI Texas2 registrations
  • National Association of Social Workers-Texas1 registration
  • Self1 registration
  • Teaching Hospitals of Texas2 registrations
  • Texas Academy of Family Physicians1 registration
  • Texas Association of Community Health Centers1 registration
  • Texas association of community health centers1 registration
  • Texas Association of Health Plans1 registration
  • Texas Council of Community Centers1 registration
  • Texas Hospital Association2 registrations
  • Texas Medical Association2 registrations
  • Texas Pediatric Society1 registration
  • Texas Women's Healthcare Coalition1 registration
  • Texas Women’s Healthcare Coalition1 registration
  • Travis County Commissioners Court1 registration

On

  • Health and Human Services Commission2 registrations
  • HHSC1 registration
Sources

27 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.

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

Fiscal

No significant fiscal implication to the State is anticipated.

LBB estimate · fiscal note version E · source

Sources

Fiscal note · version E · May 19, 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 14, 2025

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

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

Data snapshot Nov 1, 2026 at 1:58 PM CST. Grades, charges, quotes and corrections follow the published record.

Sponsors

House committee · Human Services · Committee vote 10 aye, 0 nay, 1 absent · Out of committee

Senate committee · Health & Human Services · Committee vote 8 aye, 0 nay, 1 absent · Out of committee

Subjects

Human Services--Medical Assistance

Mental Health & Substance Abuse

Women

MEDICAID

PREGNANCY & CHILDBIRTH

HEALTH & HUMAN SERVICES COMMISSION

OPIOID ABATEMENT FUND COUNCIL, TEXAS (V76AR)

Text

The text as introduced · 377 words

By: Rose
H.B. No. 5155

A BILL TO BE ENTITLED

AN ACT

relating to the continuation of a pilot program designed to improve

the quality and accessibility of care for certain Medicaid

recipients.

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

SECTION 1. Subchapter B, Chapter 526, Government Code, is

amended by adding Section 526.0060 to read as follows:

Sec. 531.0738. CONTINUATION OF THE PILOT MODEL OF CARE FOR

CERTAIN MEDICAID RECIPIENTS. (a) To the extent funds are available

for this purpose, the commission shall continue the Maternal Opioid

Misuse Model pilot program, a model of care designed to improve the

quality and accessibility of care for:

(1) pregnant women with opioid use disorder enrolled

in Medicaid during the prenatal and postpartum periods; and

(2) their children after birth.(b) This section

expires December 1, 2028.

SECTION 2 . Not later than December 31, 2028, the commission

shall prepare and submit to the legislature a report on the benefits

of the program, including measures of birth outcomes.

SECTION 3 . To the extent available for use, the Texas opioid

abatement fund council shall prioritize funding to the Maternal

Opioid Misuse Model as a grant recipient of money allocated to the

council from the Opioid Abatement Trust Fund, established by

Section 403.506.

SECTION 4. 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 5. The Health and Human Services Commission is

required to implement a provision of this Act only if the

legislature appropriates money specifically for that purpose. If

the legislature does not appropriate money specifically for that

purpose, the commission may, but is not required to, implement a

provision of this Act using other appropriations available for that

purpose.

SECTION 6. This Act takes effect immediately if it receives

a vote of two-thirds of all the members elected to each house, as

provided by Section 39, Article III, Texas Constitution. If this

Act does not receive the vote necessary for immediate effect, this

Act takes effect September 1, 2025.