TX SB638

Expands Medicaid eligibility in Texas to all individuals who qualify for federal matching funds under the Affordable Care Act (ACA) and Health Care and Education Reconciliation Act of 2010

Requires the Health and Human Services Commission to provide medical assistance to all eligible applicants and directs the executive commissioner to adopt implementing rules

Mandates an annual report due December 1 to the governor, lieutenant governor, speaker, and relevant legislative committees on expansion effects, including impacts on uninsured rates, state and local health care costs, and hospital charity/uncompensated care costs

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

Takes effect September 1, 2025, with the executive commissioner required to notify federal agencies and seek any necessary waivers for implementation