TX HB891

Establishes a reformed state Medicaid program operating under a block grant funding system if authorized by the federal government, using a risk-based managed care model with eligibility for individuals at or below 100% of the federal poverty level

Creates sliding scale subsidies for Medicaid-eligible individuals to purchase private health benefit plans, with enhanced subsidies for those choosing high-deductible plans with health savings accounts, plus additional subsidies for copayments and deductibles

Develops an alternative program to connect low-income individuals (under age 65, with income at or below 133% of federal poverty level) who don't qualify for Medicaid with private market health coverage, designed to be cost-neutral through premium tax revenues

Requires HHSC to establish a parental fee program for parents of children receiving long-term services and supports, create a dual eligible integrated care demonstration project combining Medicaid and Medicare benefits, and provide housing payment assistance for those receiving home and community-based services

Creates a 12-member Medicaid Reform Task Force to advise on program design, with a report due by December 1, 2026, and mandates studies on estate recovery program improvements and alternative income/asset limits for long-term services eligibility