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Bill

HB 5311

Relating to establishing the Texas Care Plan Medicaid buy-in program to provide health benefit plan coverage to certain persons in this state.

89th Legislature (2025) Introduced by James Talarico

Texas would create a state-administered health insurance buy-in program enabling uninsured working Texans ineligible for Medicaid to purchase affordable coverage.

Referred to Appropriations
#health&humanservicescommission(v0177) #humanservices--medicalassistance(i0905) #insurance #commissionerof(v0396) #insurance--health&accident(i0422) #medicaid(s4885)
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Bill Summary · HB 5311

Legislative bill overview

HB 5311 proposes establishing a "Texas Care Plan" Medicaid buy-in program that would allow certain individuals to purchase health coverage through a state-administered plan. The bill creates a mechanism for people who don't qualify for traditional Medicaid but need affordable health insurance to buy into a state health benefit program, similar to public option models implemented in other states.

Why is this important

Texas has one of the highest uninsured rates in the nation, with many working individuals earning too much for Medicaid but too little to afford private insurance. A buy-in program could expand coverage to this vulnerable population while potentially reducing emergency room utilization and uncompensated care costs. The program's structure and cost would significantly impact state budgets and healthcare access for low-to-moderate income Texans.

Potential points of contention

  • Program cost and state funding: Opponents may argue the state cannot afford the program without tax increases or budget reallocation; supporters counter it could reduce costs through preventive care and reduced uncompensated care
  • Private insurance market impact: Insurance industry concerns that a state-run plan could undercut private premiums or discourage participation; debate over whether this constitutes unfair competition
  • Federal authority and waivers: The program likely requires federal Medicaid waiver approval, adding uncertainty; disagreement over whether the state has proper authority to establish such a program

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

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