89R1093 MM-D By: Johnson S.B. No. 657 A BILL TO BE ENTITLED AN ACT relating to the expansion of eligibility for Medicaid to all individuals for whom federal matching money is available. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subchapter B, Chapter 32, Human Resources Code, is amended by adding Section 32.02473 to read as follows: Sec. 32.02473. EXPANDED ELIGIBILITY FOR MEDICAID. The executive commissioner shall prepare and seek a waiver to the state Medicaid plan under Section 1115 of the Social Security Act (42 U.S.C. Section 1315) or other applicable federal law to expand to the maximum extent permitted by federal law the categories of individuals eligible for Medicaid benefits to include all individuals for whom federal matching funds are available. The waiver must be designed to: (1) maximize the reduction in the number of uninsured residents of this state; (2) promote personal responsibility with respect to health care; (3) increase the efficiency of the delivery of health care services; (4) increase the accessibility of health care services; and (5) reduce health care costs. SECTION 2. As soon as practicable after the effective date of this Act, the executive commissioner of the Health and Human Services Commission shall apply for and actively pursue the waiver required by Section 32.02473, Human Resources Code, as added by this Act, from the Centers for Medicare and Medicaid Services or any other federal agency. The commission may delay implementing Section 32.02473, Human Resources Code, as added by this Act, until the waiver applied for under this section is granted. SECTION 3. This Act takes effect immediately if it receives a vote of two-thirds of all the members elected to each house, as provided by Section 39, Article III, Texas Constitution. If this Act does not receive the vote necessary for immediate effect, this Act takes effect September 1, 2025.