TX HB4910

Requires the Health and Human Services Commission to expand Medicaid eligibility to all individuals who qualify for federal matching funds under the Affordable Care Act (ACA Medicaid expansion)

Directs the executive commissioner to adopt rules for implementing the expanded medical assistance program

Mandates an annual report due December 1 to the governor, lieutenant governor, speaker, and legislators on the expansion's effects, including impacts on uninsured rates, state and local health care costs, and hospital uncompensated care

Applies to eligibility determinations and recertifications made on or after the implementation date, regardless of when individuals originally applied

Takes effect January 1, 2026, with the executive commissioner required to notify federal agencies and seek any necessary waivers as soon as possible after the effective date