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SJR 6

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 Judith Zaffirini

Texas constitutional amendment would enable Medicaid expansion to cover 2 million uninsured low-income adults under ACA, subject to voter approval.

Referred to Health & Human Services
#humanservices--medicalassistance(i0905) #medicaid(s4885) #resolutions--constitutionalamendments(i0661)
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Bill Summary · SJR 6

Legislative bill overview

SJR 6 proposes a constitutional amendment to Texas that would allow the state to expand Medicaid eligibility under the Affordable Care Act (ACA). This would enable Texas to receive federal matching funds to cover more low-income adults who currently fall into a coverage gap—earning too much for traditional Medicaid but too little to qualify for marketplace insurance subsidies. The amendment would require voter approval through a statewide referendum.

Why is this important

Texas is one of 10 states that has not expanded Medicaid, leaving approximately 2 million uninsured residents in the coverage gap. Expansion would extend health insurance to more low-income adults, increase preventive care access, and generate federal dollars into the state healthcare system. However, it also represents a significant policy shift for a state that has historically resisted ACA expansion, with fiscal and ideological implications.

Potential points of contention

  • State fiscal commitment: While the federal government covers 90% of expansion costs, Texas would still bear ongoing state costs that must be budgeted against other priorities
  • Ideological opposition: Some oppose expansion as entitlement growth; others support it as pragmatic healthcare access and economic development
  • Political feasibility: The amendment faces a substantial path requiring Senate passage, House passage, and voter approval—each step represents a political hurdle in a Republican-controlled legislature

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

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