TX HB2604

Requires the Health and Human Services Commission to provide Medicaid coverage to all individuals eligible for federal matching funds under the Affordable Care Act (ACA), effectively expanding Medicaid in Texas

Mandates the executive commissioner adopt rules for implementing the expanded eligibility requirements

Requires annual reports to the governor, lieutenant governor, speaker, and legislators by December 1 each year on expansion effects, including impacts 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

First annual report on expansion effects not required until December 1, 2026