TX HB5244

Establishes the Texas Plan demonstration program to provide health care services to Texas residents ages 19-64 who are U.S. citizens or permanent residents and not eligible for Medicaid under December 31, 2024 criteria

Requires the Health and Human Services Commission to seek a Section 1115 federal waiver or block grant to fund the program, with implementation required by September 1, 2026, and the program expiring September 1, 2031

Creates individual health benefit accounts for participants funded with 25% of allocated per capita funds for primary care, dental, and prescription costs, with the remaining 75% going to a "med-pool" risk pool for specialty and major medical care

Establishes a seven-member board of directors to govern the med-pool, which will cover specialty services including emergency, hospital, surgical, psychiatric, and other major medical care at Medicare reimbursement rates for emergency services

Emphasizes price and quality transparency by requiring health care providers to register and submit pricing information, and authorizes the commission to develop a public database of high-value providers to help participants make informed decisions