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HB 283

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

89th Legislature, 2nd Called Session (2025) Introduced by John Bucy

Texas bill expanding Medicaid to 138% poverty line to cover 640,000 uninsured adults, requiring state budget commitment while accessing 90% federal matching funds.

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#health&humanservicescommission(v0177) #humanservices--medicalassistance(i0905) #insurance--life #health&accident(i0440) #medicaid(s4885)
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Bill Summary · HB 283

Legislative bill overview

HB 283 proposes expanding Texas Medicaid eligibility to include individuals covered under the federal Affordable Care Act's expansion provisions. This would extend coverage to adults earning up to 138% of the federal poverty line, a group currently excluded from Texas's more restrictive Medicaid program. The bill represents a significant shift from Texas's longstanding decision to not adopt the ACA's optional Medicaid expansion.

Why is this important

Texas is one of 12 states that has not expanded Medicaid, leaving approximately 640,000 low-income uninsured Texans without coverage eligibility. Expanding would potentially reduce uninsured rates, increase access to preventive care, and generate federal matching funds (90% federal, 10% state). However, it would also require state budget appropriations and represents a major policy reversal for a conservative state government.

Potential points of contention

  • State budget impact: Requires ongoing state funding commitment despite federal matching; budget pressures could affect other programs
  • Ideological disagreement: Represents expansion of government healthcare program, opposed by conservative lawmakers on principle
  • Work requirements debate: Questions about whether expansion should include work or health-related requirements for beneficiaries
  • Federal funding reliability: Concerns about federal government reducing match rates or program changes affecting long-term state costs

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

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