TX HB1423

Expands Medicaid eligibility in Texas to all individuals who qualify for federal matching funds under the Affordable Care Act (ACA)

Requires the Health and Human Services Commission to adopt rules for implementing the expanded medical assistance program

Mandates an annual report by December 1 to the governor, lieutenant governor, speaker of the house, and relevant legislative committees on the expansion's effects on uninsured rates, state and local health care costs, and hospital charity/uncompensated care costs

Takes effect January 1, 2026, but only if voters approve a related constitutional amendment proposed by the 89th Legislature requiring Medicaid expansion

Applies to initial eligibility determinations and recertifications made on or after January 1, 2026, regardless of application date