Monitoring the Session

SB 229

Alvarado Bill Expands Texas Medicaid Under The Affordable Care Act

Filed

Verdict: No flags

No flagsInitial review
Sen. Carol AlvaradoDSenate 6

Initial review · graded Nov 9, 2026 · How we grade

Caption

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

Caption from analyzed text · version I.

Summary

Low-income adults newly eligible wherever federal matching money is available. Starts September 1, 2027.

The bill orders the state health agency to give Medicaid to everyone who applies and for whom federal matching money is available under the Affordable Care Act. It touches low-income adults who would become newly eligible, along with the Health and Human Services Commission, which must write rules and notify federal agencies. Starting September 1, 2027, Texas would expand Medicaid eligibility to the full group the federal law will help pay for, with any needed federal waivers sought first.

Labels

Labels: ZOMBIE BILL. Died 2 times: 88R SB 125 (Died in committee) and 89R SB 255 (Died in committee). Checked against 88R and 89R only.BACK FROM THE DEAD. Same text as a bill filed before that died: 88R SB 125 (Died in committee) and 89R SB 255 (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-SB229 · 2026-11-09

SOLD BY

+ 2 more authors

ITEM

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

WHAT IT DOES

Low-income adults newly eligible wherever federal matching money is available. Starts September 1, 2027.

The bill orders the state health agency to give Medicaid to everyone who applies and for whom federal matching money is available under the Affordable Care Act. It touches low-income adults who would become newly eligible, along with the Health and Human Services Commission, which must write rules and notify federal agencies. Starting September 1, 2027, Texas would expand Medicaid eligibility to the full group the federal law will help pay for, with any needed federal waivers sought first.

CHARGES

[ ] NONE FOUND

TOTAL

No fiscal note in the loaded record.

HISTORY

  1. Received by the Secretary of the Senate
  2. Filed
FILED UNDER

MEDICAID EXPANSION

THE TEXT

…“the commission shall provide medical assistance to all individuals who apply for that assistance and for whom federal matching money is available under the Patient Protection and Affordable Care Act”…

Bill text, introduced version (I)

The bill expands Medicaid to every applicant the federal Affordable Care Act match covers, so the expansion is tied to federal money arriving.

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 · Oct 30, 2024 to Jun 19, 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 Sands PAC$25,000.00

Texas Sands PAC

$25,000.00

Cash
$25,000.00
Paid by others
$0.00
Total
$25,000.00

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 · Dec 6, 2024 to Mar 16, 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: 101012403, 101030499, 101059972.

Texas REALTORS Political Action Committee$20,000.00

Texas REALTORS Political Action Committee

$20,000.00

Cash
$20,000.00
Paid by others
$0.00
Total
$20,000.00

Also funds 140 other sitting lawmakers.

Derived recipient stock · Jul 2, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Jun 23, 2025 to Dec 8, 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: 101007246, 101030499.

Texas Trial Lawyers Association PAC$20,000.00

Texas Trial Lawyers Association PAC

$20,000.00

Cash
$20,000.00
Paid by others
$0.00
Total
$20,000.00

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 · Oct 30, 2024 to Dec 9, 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: 101012403, 101030499.

Money

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

×

Texas Sands PAC

$25,000.00

Cash
$25,000.00
Paid by others
$0.00
Total
$25,000.00

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 · Dec 6, 2024 to Mar 16, 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: 101012403, 101030499, 101059972.

×

Texas REALTORS Political Action Committee

$20,000.00

Cash
$20,000.00
Paid by others
$0.00
Total
$20,000.00

Also funds 140 other sitting lawmakers.

Derived recipient stock · Jul 2, 2024 to Oct 24, 2026. State data as of Nov 4, 2026.

TEC account match.

Team
Sources

Derived itemized flow · Jun 23, 2025 to Dec 8, 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: 101007246, 101030499.

×

Texas Trial Lawyers Association PAC

$20,000.00

Cash
$20,000.00
Paid by others
$0.00
Total
$20,000.00

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 · Oct 30, 2024 to Dec 9, 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: 101012403, 101030499.

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 9, 2026, against the published rubric.

FILED BEFORE

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

88R SB 125

by Sen. Alvarado, same lead author · Died in committee · same text

Introduced text

Last action, Feb 15, 2023: Referred to Health & Human Services

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

Caption, 88R bill history

89R SB 255

by Sen. Alvarado, same lead author · Died in committee · same text

Introduced text

Last action, Feb 3, 2025: Referred to Health & Human Services

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

Caption, 89R bill history

Sources

Texas Senate · Filed Nov 9, 2026

11/09/2026 S Filed

Texas Legislature Online · Introduced

Data snapshot Nov 10, 2026 at 2:40 AM CST. Grades, charges, quotes and corrections follow the published record.

Subjects

Human Services--Medical Assistance

MEDICAID

HEALTH & HUMAN SERVICES COMMISSION

Text

The text as introduced · 338 words

90R2691 CMO-D

By: Alvarado, et al.
S.B. No. 229

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. Subchapter B, Chapter 32, Human Resources Code,

is amended by adding Section 32.02473 to read as follows:

Sec. 32.02473. 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 money is 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.

SECTION 2. Section 32.02473, 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

the date the section is implemented, 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 32.02473, Human

Resources Code, as added by this Act, including notifying

appropriate federal agencies of that expanded eligibility.

SECTION 4. 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 5. This Act takes effect September 1, 2027.