Monitoring the Session

HB 1111

Bernal Bill Lets Counties Opt Into Medicaid Expansion On Their Own

Filed

Verdict: No flags

No flagsHARD LEFT. Filed under Medicaid expansion, a beat on the HARD LEFT list. The label reads the bill, never the author.Initial review
Rep. Diego M. BernalDHouse 123

Initial review · graded Nov 12, 2026 · How we grade

Caption

relating to the expansion of eligibility for Medicaid in certain counties under the federal Patient Protection and Affordable Care Act.

Caption from analyzed text · version I.

Summary

County asks, state must seek a federal waiver. Request rules due by December 1, 2027.

The bill requires the state health commission chief to ask the federal government for a waiver that lets a county offer Medicaid to residents who are not now eligible, whenever that county asks. It touches counties that opt in, adults those counties could newly cover with federal Affordable Care Act matching money, and the state health commission, which must write the request rules by December 1, 2027. If the waiver is approved, an opting county could run its own Medicaid expansion, with the waiver spelling out who pays the state share and how residents qualify.

Labels

Labels: ZOMBIE BILL. Died 2 times: 88R HB 204 (Died in committee) and 89R HB 792 (Died in committee). Checked against 88R and 89R only.BACK FROM THE DEAD. Same text as a bill filed before that died: 88R HB 204 (Died in committee) and 89R HB 792 (Died in committee). Filed in 3 sessions, counting this one. Checked against 88R and 89R only.TRY NO. 3. Filed in 3 sessions: 88R, 89R and 90R. Checked against 88R and 89R only.

Receipt

The receipt

90R-HB1111 · 2026-11-12

SOLD BY

ITEM

relating to the expansion of eligibility for Medicaid in certain counties under the federal Patient Protection and Affordable Care Act.

WHAT IT DOES

County asks, state must seek a federal waiver. Request rules due by December 1, 2027.

The bill requires the state health commission chief to ask the federal government for a waiver that lets a county offer Medicaid to residents who are not now eligible, whenever that county asks. It touches counties that opt in, adults those counties could newly cover with federal Affordable Care Act matching money, and the state health commission, which must write the request rules by December 1, 2027. If the waiver is approved, an opting county could run its own Medicaid expansion, with the waiver spelling out who pays the state share and how residents qualify.

CHARGES

[ ] NONE FOUND

TOTAL

No fiscal note in the loaded record.

HISTORY

2026-11-12 Filed (per the TLO filing feed)

FILED UNDER

MEDICAID EXPANSION

THE TEXT

…“expand the categories of individuals eligible for Medicaid benefits”…

Bill text, introduced version (I)

The bill lets any county that asks expand Medicaid to residents not now eligible, using federal Affordable Care Act matching funds through a state-sought waiver.

No flags

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 2, 2024 to Jun 11, 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$10,000.00

Texas Trial Lawyers Association PAC

$10,000.00

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

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 · Dec 13, 2024 to Feb 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.

Report IDs: 100987101, 101032904, 101060248.

Texas Sands PAC$8,000.00

Texas Sands PAC

$8,000.00

Cash
$8,000.00
Paid by others
$0.00
Total
$8,000.00

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 18, 2024 to Dec 10, 2024. 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: 100987101.

Texas HDCC$7,000.00

Texas HDCC

$7,000.00

Cash
$7,000.00
Paid by others
$0.00
Total
$7,000.00

Also funds 2 other sitting lawmakers.

Derived recipient stock · Nov 3, 2024 to May 12, 2026. State data as of Nov 4, 2026.

Name match, not a verified identity: normalized filed name and state.

Sources

Derived itemized flow · on Apr 30, 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: 101060248.

Money

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

×

Texas Trial Lawyers Association PAC

$10,000.00

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

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 · Dec 13, 2024 to Feb 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.

Report IDs: 100987101, 101032904, 101060248.

×

Texas Sands PAC

$8,000.00

Cash
$8,000.00
Paid by others
$0.00
Total
$8,000.00

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 18, 2024 to Dec 10, 2024. 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: 100987101.

×

Texas HDCC

$7,000.00

Cash
$7,000.00
Paid by others
$0.00
Total
$7,000.00

Also funds 2 other sitting lawmakers.

Derived recipient stock · Nov 3, 2024 to May 12, 2026. State data as of Nov 4, 2026.

Name match, not a verified identity: normalized filed name and state.

Sources

Derived itemized flow · on Apr 30, 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: 101060248.

Votes

No floor vote loaded for this bill.

Fiscal

No fiscal note in the loaded record.

How this was graded

Analysis of text version I by a super-expensive superintelligence, Nov 12, 2026, against the published rubric.

FILED BEFORE

Filed 3 times: 88R, 89R and now. Checked against 88R and 89R only.

88R HB 204

by Rep. Bernal, same lead author · Died in committee · same text

Introduced text

Last action, Feb 23, 2023: Referred to Health Care Reform, Select

Relating to the expansion of eligibility for Medicaid in certain counties under the federal Patient Protection and Affordable Care Act.

Caption, 88R bill history

89R HB 792

by Rep. Bernal, same lead author · Died in committee · same text

Introduced text

Last action, Mar 5, 2025: Referred to s/c on Dis Prev & Women's & Children's Health by Speaker

Relating to the expansion of eligibility for Medicaid in certain counties under the federal Patient Protection and Affordable Care Act.

Caption, 89R bill history

Sources

Texas House · Filed Nov 12, 2026

2026-11-12 Filed (per the TLO filing feed)

Texas Legislature Online · Introduced text: HTML · PDF

Data snapshot Nov 12, 2026 at 5:07 PM CST. Grades, charges, quotes and corrections follow the published record.

Text

The text as introduced · 505 words

By: Bernal
H.B. No. 1111

A BILL TO BE ENTITLED

AN ACT

relating to the expansion of eligibility for Medicaid in certain

counties under the federal Patient Protection and Affordable Care

Act.

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

SECTION 1. Subtitle I, Title 4, Government Code, is amended

by adding Chapter 540 to read as follows:

CHAPTER 540. FEDERAL WAIVER TO EXPAND MEDICAID IN CERTAIN COUNTIES

Sec. 540.0001. DEFINITION. Notwithstanding Section

531.001, in this chapter, "Medicaid" means the medical assistance

program established under Title XIX, Social Security Act (42 U.S.C.

Section 1396 et seq.).

Sec. 540.0002. FEDERAL AUTHORIZATION FOR MEDICAID

EXPANSION IN CERTAIN COUNTIES. (a) On a county's request and

notwithstanding any other law, the executive commissioner shall, on

the county's behalf, seek a waiver under Section 1115 of the Social

Security Act (42 U.S.C. Section 1315) to the state Medicaid plan to

expand the categories of individuals eligible for Medicaid benefits

by allowing the county to provide Medicaid benefits to any resident

of the county:

(1) who is not otherwise eligible to receive Medicaid

benefits under the program established under Chapter 32, Human

Resources Code, and operated by this state, including through a

waiver, other than a waiver sought under this section, to the

program;

(2) who applies to receive Medicaid benefits; and

(3) 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 Medicaid benefits.

(b) The terms of a waiver under this section must:

(1) specify how, and with the assistance of what

entities, the county will implement and operate a delivery system

for the provision of Medicaid benefits to individuals described by

Subsection (a);

(2) specify the commission's role in facilitating the

provision of those Medicaid benefits;

(3) identify the sources of money to be used to pay

this state's share of the cost of Medicaid benefits the county

provides;

(4) establish qualifications for an individual to be

considered a resident of the county for purposes of receiving

Medicaid benefits from the county; and

(5) if appropriate, prescribe changes to the

commission's eligibility determination process for Medicaid

benefits to accommodate the expanded categories of individuals

eligible to receive Medicaid benefits from the county.

(c) The executive commissioner shall adopt rules necessary

to implement this section.

SECTION 2. Not later than December 1, 2027, the executive

commissioner of the Health and Human Services Commission shall

adopt rules necessary to implement Section 540.0002, Government

Code, as added by this Act, including rules that specify procedures

by which a county may request that the executive commissioner seek a

waiver under that section.

SECTION 3. 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, 2027.