Medicaid Expansion Bills – What You Need to Know

Every Texan strongly supports all the coverage expansion/Medicaid expansion bills, including SB 117 and HB 3871, which have substantial bipartisan support. Bipartisan support is key to getting Texas to move out of our dead-last place in covering parents and other low-income working adults in Medicaid. 

  • Texas Legislators have filed over a dozen proposed bills to provide affordable coverage to low-wage Texas adults, who are currently left out of both Texas Medicaid and the Obamacare/ACA marketplace
  • All of these bills would be paid for with 90% federal funding (Texas would pay 10 cents on the dollar for care for newly covered adults).  
  • Most of these bills propose a simple extension of the current Texas Medicaid program model to these adults, though more modest benefits and the addition of co-payments for the newly covered adults are allowed by federal law.  This is how New Mexico, Louisiana, and Oklahoma currently implement coverage.  
  • SB 117 and HB 3871 propose a different route, inspired by Indiana’s coverage expansion, that would use a “waiver” from federal Medicaid (“1115 waiver”) to create a more complex program.  (The waiver route was also used by Arkansas for coverage expansion to their mostly-rural population and their limited Managed Care market resources.)
    • This model of coverage would also earn the 90% federal match, and would cover the same income group of adults up to 138% federal poverty income (that’s less than $18,000/year for a single adult, or about $30,000 for a parent with two children).
    • These bills propose to create two options for coverage, one of which would allow enrollees to have an account to pay for certain co-payments and deductibles, and to earn rewards for healthy behaviors.
    • The bill follows the Indiana model from several years ago, but includes some policies that would have to be tweaked in order to be approved by federal Medicaid authorities under current federal policy.  

Deeper Dive: Click here to read more about all the filed Medicaid Expansion bills and their differences.

Every Texan believes that making good, affordable coverage available for the millions of hard-working Texas adults who can’t currently afford health insurance is of such critical importance to Texas that we must participate in working toward a compromise approach that balances two goals:  

  1. To win support of Texas Legislators and gain passage; and 
  2. Meet federal standards so that it can gain approval, earn the 90% federal funding, and cover Texas’ lowest-wage adults who have no options today.  

Every Texan Supports all the bills that would cover all eligible adults up to 138% of the federal poverty income and qualify for 90% federal match.

  1. While the simpler coverage model bills would be less complicated, faster, and less expensive to implement we are also very encouraged by the bipartisan authorship of SB 117 and HB 3871 and are equally committed to working with the Legislature and our diverse partners to advance and improve these bills to ensure that they can be speedily approved and implemented to cover a million or more uninsured Texas adults.
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