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SJR 32

Proposing a constitutional amendment requiring the state to expand eligibility for Medicaid to certain individuals under the federal Patient Protection and Affordable Care Act.

89th Legislature (2025)

Texas constitutional amendment authorizing Medicaid expansion to cover low-income adults under the Affordable Care Act if the legislature approves.

Referred to Health & Human Services
#humanservices--medicalassistance(i0905) #medicaid(s4885) #resolutions--constitutionalamendments(i0661)
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Bill Summary · SJR 32

Legislative bill overview

SJR 32 proposes a constitutional amendment that would authorize Texas to expand Medicaid eligibility to additional individuals under the Affordable Care Act (ACA). Currently, Texas has not adopted the ACA's Medicaid expansion, which would cover adults earning up to 138% of the federal poverty line. This amendment would remove any state constitutional barriers to such expansion if the legislature chooses to pursue it.

Why is this important

Texas is one of twelve states that has not expanded Medicaid, leaving approximately 650,000 low-income adults without coverage options. Expansion could increase access to healthcare for vulnerable populations, generate federal matching funds, and potentially reduce uncompensated care costs in hospitals. However, it would also increase state budget obligations and represent a significant policy shift in a traditionally conservative state.

Potential points of contention

  • State budget impact: Expansion requires ongoing state spending increases, a concern for fiscal conservatives during economic uncertainty
  • Federal funding reliability: States rely on federal matching funds that could theoretically be reduced or eliminated in future administrations
  • Philosophical opposition: Many Texas Republicans oppose the ACA on principle and view expansion as endorsing federal overreach into healthcare policy
  • Existing coverage gaps: Debate over whether expansion is the most effective way to address healthcare access versus targeted programs or market-based solutions

Compiled from official sources — confirm details with the bill’s official record.

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