Zaffirini’s bill expanding Medicaid under the Affordable Care Act

The text as introduced · 519 words

89R151 MM-F

By: Zaffirini, Cook
S.B. No. 45

A BILL TO BE ENTITLED

AN ACT

relating to the expansion of eligibility for Medicaid to certain

individuals under the federal Patient Protection and Affordable

Care Act.

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

SECTION 1. Chapter 32, Human Resources Code, is amended by

adding Subchapter H to read as follows:

SUBCHAPTER H. EXPANSION OF ELIGIBILITY FOR MEDICAL ASSISTANCE

Sec. 32.351. EXPANDED ELIGIBILITY FOR MEDICAL ASSISTANCE

UNDER PATIENT PROTECTION AND AFFORDABLE CARE ACT. (a)

Notwithstanding any other law, the commission shall provide medical

assistance to all individuals who apply for that assistance and for

whom federal matching funds are available under the Patient

Protection and Affordable Care Act (Pub. L. No. 111-148), as

amended by the Health Care and Education Reconciliation Act of 2010

(Pub. L. No. 111-152), to provide that assistance.

(b) The executive commissioner shall adopt rules regarding

the provision of medical assistance as required by this section.

Sec. 32.352. ANNUAL REPORT ON EXPANDED ELIGIBILITY FOR

MEDICAL ASSISTANCE. Not later than December 1 of each year, the

commission shall report to the governor, the lieutenant governor,

the speaker of the house of representatives, and the standing

committees of the senate and the house of representatives having

primary jurisdiction over the medical assistance program on the

effects of expanding eligibility for medical assistance under

Section 32.351, including the effects on:

(1) the number of individuals in this state who do not

have health benefits coverage;

(2) state health care costs, including costs relating

to programs funded with money appropriated out of the general

revenue fund;

(3) local health care costs; and

(4) charity care and uncompensated care costs for

hospitals.

SECTION 2. Section 32.351, Human Resources Code, as added

by this Act, applies only to an initial determination or

recertification of eligibility of an individual for medical

assistance under Chapter 32, Human Resources Code, made on or after

January 1, 2026, regardless of the date the individual applied for

that assistance.

SECTION 3. As soon as possible after the effective date of

this Act, the executive commissioner of the Health and Human

Services Commission shall take all necessary actions to expand

eligibility for medical assistance under Chapter 32, Human

Resources Code, in accordance with Section 32.351, Human Resources

Code, as added by this Act, including notifying appropriate federal

agencies of that expanded eligibility. If before implementing any

provision of this Act a state agency determines that any other

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 January 1, 2026, but only

if the constitutional amendment proposed by the 89th Legislature,

Regular Session, 2025, requiring the state to expand eligibility

for Medicaid to all individuals for whom federal matching funds are

available under the federal Patient Protection and Affordable Care

Act is approved by the voters. If that amendment is not approved by

the voters, this Act has no effect.