WeVote
Log In

Bill

Bill

HJR 69

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) Introduced by Diego Bernal

Constitutional amendment authorizing Texas to expand Medicaid under the ACA, potentially covering 1-2 million uninsured low-income residents pending voter approval.

Referred to Appropriations
#humanservices--medicalassistance(i0905) #medicaid(s4885) #resolutions--constitutionalamendments(i0661)
0
WeVote Research Nonpartisan
Bill Summary · HJR 69

Legislative bill overview

HJR 69 proposes a constitutional amendment that would authorize Texas to expand Medicaid eligibility under the Affordable Care Act's provisions. This would allow the state legislature to cover additional low-income individuals who currently fall into the "coverage gap"—those earning too much for current Medicaid but too little to qualify for ACA subsidies. The amendment requires voter approval in a statewide referendum to take effect.

Why is this important

Texas is one of the few states that has not expanded Medicaid, leaving approximately 1-2 million uninsured residents without coverage options. Expansion could increase access to preventive care, reduce uncompensated hospital costs, and generate federal matching funds (roughly 9:1 federal-to-state ratio). However, it would also require ongoing state budget commitments and potentially affect healthcare delivery systems statewide.

Potential points of contention

  • State budget impact: While federal funding is generous, Texas would still incur costs; debates center on whether these funds should go to Medicaid expansion versus other priorities like education or transportation
  • Conservative opposition: Concerns that expansion increases government dependency, federal overreach, and aligns with the ACA, which remains politically contentious in Texas
  • Implementation complexity: Questions about whether Texas has adequate healthcare infrastructure, provider capacity, and administrative systems to manage a significantly expanded enrollment base

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

Sign in to ask a question.