Texas Democrats File Bills to Expand Medicaid Eligibility

Governor-elect Gina Hinojosa and Lieutenant Governor-elect Vikki Goodwin have prioritized expanding Medicaid following a Democratic sweep of Texas statewide offices. The expansion could provide health coverage to over 1 million additional Texans and secure up to $10 billion in annual federal funding. To initiate this, State Representative John Bucy III filed two bills on November 9: HB 101, which requires a state constitutional amendment and would take effect in 2028, and HB 102, which would begin September 1, 2027, without voter approval. State Senator Judith Zaffirini filed SB 31 as a companion to HB 101.

Despite the executive shift, Hinojosa faces significant hurdles. Texas law generally prohibits altering Medicaid eligibility via executive order, and Republicans maintain control of the state Senate. Additionally, the federal One Big Beautiful Bill Act of 2025 imposes work-reporting requirements for recipients under 65. To address these administrative costs, State Representative Donna Howard is discussing a trigger bill that would activate expansion only if the incoming Democratic majority in Congress repeals those federal restrictions.

These efforts mark a sharp reversal from the tenure of former Governor Greg Abbott, who blocked expansion for 12 years. The 90th Texas Legislature is scheduled to convene on January 12, 2027, to consider the prefiled legislation.