Monitoring the Session

SB 31

Zaffirini Bill Expands Medicaid Under The Affordable Care Act

Filed

Verdict: No flags

No flagsInitial review
Sen. Judith ZaffiriniDSenate 21

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 qualify starting January 1, 2028. Only if voters approve a constitutional amendment.

This bill orders the state health commission to give Medicaid to everyone who applies and qualifies for federal matching money under the federal Affordable Care Act, and to report each year on the effects. It touches low-income adults who would newly qualify, the Health and Human Services Commission, and state and local health budgets. Coverage would start with eligibility decisions made on or after January 1, 2028, but only if voters approve a matching constitutional amendment, and the agency may hold off on any piece that needs more federal permission.

Labels

Labels: ZOMBIE BILL. Died 2 times: 88R SB 39 (Died in committee) and 89R SB 45 (Died in committee). Checked against 88R and 89R only.BACK FROM THE DEAD. Same text as a bill filed before that died: 88R SB 39 (Died in committee) and 89R SB 45 (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-SB31 · 2026-11-09

SOLD BY

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 qualify starting January 1, 2028. Only if voters approve a constitutional amendment.

This bill orders the state health commission to give Medicaid to everyone who applies and qualifies for federal matching money under the federal Affordable Care Act, and to report each year on the effects. It touches low-income adults who would newly qualify, the Health and Human Services Commission, and state and local health budgets. Coverage would start with eligibility decisions made on or after January 1, 2028, but only if voters approve a matching constitutional amendment, and the agency may hold off on any piece that needs more federal permission.

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 funds are available under the Patient Protection and Affordable Care Act”…

Bill text, introduced version (I)

The bill widens Medicaid eligibility to everyone the federal Affordable Care Act expansion would cover, tied to the availability of federal matching money.

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 1, 2024 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.

Carlos M. Zaffirini Jr$110,000.00
Killam Development Ltd.$72,700.00

Killam Development Ltd.

$72,700.00

Cash
$10,000.00
Paid by others
$62,700.00
Total
$72,700.00
advertising $33,000.00media $29,700.00

Also funds 3 other sitting lawmakers.

Derived recipient stock · Dec 9, 2024 to Sep 28, 2026. State data as of Nov 4, 2026.

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

Sources

Derived itemized flow · Dec 16, 2025 to Aug 20, 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: 101011018, 101057658.

Texas Trial Lawyers Association PAC$60,000.00

Texas Trial Lawyers Association PAC

$60,000.00

Cash
$60,000.00
Paid by others
$0.00
Total
$60,000.00

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 · Nov 11, 2024 to Aug 31, 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: 100959783, 100987492, 101011018, 101035338, 101057658.

Money

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

×

Killam Development Ltd.

$72,700.00

Cash
$10,000.00
Paid by others
$62,700.00
Total
$72,700.00
advertising $33,000.00media $29,700.00

Also funds 3 other sitting lawmakers.

Derived recipient stock · Dec 9, 2024 to Sep 28, 2026. State data as of Nov 4, 2026.

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

Sources

Derived itemized flow · Dec 16, 2025 to Aug 20, 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: 101011018, 101057658.

×

Texas Trial Lawyers Association PAC

$60,000.00

Cash
$60,000.00
Paid by others
$0.00
Total
$60,000.00

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 · Nov 11, 2024 to Aug 31, 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: 100959783, 100987492, 101011018, 101035338, 101057658.

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 39

by Sen. Zaffirini, 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 45

by Sen. Zaffirini, 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 2:39 AM CST. Grades, charges, quotes and corrections follow the published record.

Companion

HB 101 by Bucy (identical)

HB 855 by Anchía (identical)

Subjects

Human Services--Medical Assistance

MEDICAID

HEALTH & HUMAN SERVICES COMMISSION

Text

The text as introduced · 518 words

90R613 LRM-F

By: Zaffirini
S.B. No. 31

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, 2028, 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, 2028, but only

if the constitutional amendment proposed by the 90th Legislature,

Regular Session, 2027, 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.