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HB 262

Relating to the expansion of eligibility for Medicaid to certain individuals under the federal Patient Protection and Affordable Care Act.

89th Legislature (2025) Introduced by John Bucy

HB 262 expands Texas Medicaid to cover low-income adults under ACA provisions, potentially insuring 600,000+ currently uninsured Texans while requiring state funding commitment.

Referred to Appropriations
#health&humanservicescommission(v0177) #humanservices--medicalassistance(i0905) #medicaid(s4885)
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Bill Summary · HB 262

Legislative bill overview

HB 262 would expand Texas Medicaid eligibility to certain individuals under provisions of the Affordable Care Act (ACA). The bill specifically addresses coverage for adults who currently fall into the "coverage gap"—those earning too much for traditional Medicaid but too little to qualify for ACA subsidies. This represents a significant shift in Texas's current Medicaid policy, which has not adopted ACA's optional Medicaid expansion.

Why is this important

Approximately 600,000+ Texans currently lack health insurance coverage due to this gap. Expanding Medicaid eligibility would provide healthcare access to working-age adults with minimal income, potentially reducing uncompensated care costs for hospitals and emergency rooms. The expansion also affects federal funding, as the ACA initially covered 100% of expansion costs (now declining to 90%), creating budget implications for both state and federal government.

Potential points of contention

  • State budget cost: Texas would assume 10% of expansion costs by 2027, requiring new spending or reallocation of existing funds during a period of competing budget priorities
  • Philosophical disagreement: Some view Medicaid expansion as federal overreach or government dependency; others see it as essential healthcare access for vulnerable populations
  • Implementation complexity: Texas would need to restructure its Medicaid system and determine eligibility thresholds, potentially requiring extensive administrative changes and IT infrastructure updates

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

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