Texas Democrats filed two Medicaid expansion proposals Monday, November 9, offering different routes to extend eligibility under the Affordable Care Act following their election victories. One bill would depend on voters approving a state constitutional amendment; the other would not.
State Rep. John Bucy III (D-District 136) filed HB 101 and HB 102 on the first day lawmakers could prefile legislation for the 90th Texas Legislature. Both would require the Texas Health and Human Services Commission to extend Medicaid eligibility to applicants for whom federal matching funds are available under the law.
Voter Approval Would Determine One Proposal
HB 101 would take effect January 1, 2028, only if voters approve a constitutional amendment requiring Medicaid expansion. Its text says the bill would have no effect if the amendment fails. The amendment itself would require separate legislative action before voters could consider it.
HB 102 sets a September 1, 2027, effective date without conditioning expansion on a constitutional amendment. Both bills allow agencies to delay implementation of affected provisions while awaiting necessary federal authorizations. An effective date would not necessarily be the first day of new enrollment.
The official HB 101 history identifies SB 31, by state Sen. Judith Zaffirini (D-District 21), as an identical companion. The record does not establish whether either measure will advance.
Annual Reports Would Track State and Local Costs
The bills would require HHSC to submit a report by December 1 each year to the governor, lieutenant governor, House speaker, and relevant legislative committees. The report would assess uninsured Texans, state and local health care costs, and hospitals’ charity care and uncompensated care expenses.
Both proposals explicitly include health care costs associated with state general revenue spending. Neither introduced bill sets a spending ceiling or provides a numerical fiscal estimate.
The federal government generally pays 90% of qualifying newly eligible adults’ Medicaid benefit costs, with states paying the remaining 10%, according to federal guidance. That matching rate does not establish the total future cost of a Texas expansion or account for every administrative expense.
Federal Work Rules Add a Requirement
Under a federal rule issued in June, states generally must implement Medicaid community-engagement requirements by January 1, 2027. Covered adults must generally satisfy 80 hours a month of qualifying work or other activities or meet an allowed alternative; exceptions and exclusions apply. States must also verify compliance.
Neither Bucy bill specifically outlines those work rules. Any expansion would have to operate within applicable federal eligibility requirements.
Changed Political Landscape, Uncertain Outcome
Texas was one of 10 states that had not adopted the ACA Medicaid expansion as of November 2026, according to KFF’s tracking.
Democrats won the governor’s office and control of the Texas House in the November 3 election, while Republicans retained a Senate majority. The incoming leaders’ priorities were previously reported by The Dallas Express.
Bucy’s attempt to add Medicaid expansion to the 2025 state budget was defeated. The 90th Legislature is scheduled to convene January 12, 2027, according to the Texas Legislative Council’s calendar. Neither newly filed bill has become law.
Provided by Dallas Express
