HB 792

relating to the expansion of eligibility for Medicaid in certain
counties under the federal Patient Protection and Affordable Care
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  Subtitle I, Title 4, Government Code, is amended
by adding Chapter 540 to read as follows:
CHAPTER 540.  FEDERAL WAIVER TO EXPAND MEDICAID IN CERTAIN COUNTIES
Sec. 540.0001.  DEFINITION.  Notwithstanding Section
531.001, in this chapter, "Medicaid" means the medical assistance
program established under Title XIX, Social Security Act (42 U.S.C.
Sec. 540.0002.  FEDERAL AUTHORIZATION FOR MEDICAID
EXPANSION IN CERTAIN COUNTIES.  (a)  On a county's request and
notwithstanding any other law, the executive commissioner shall, on
the county's behalf, seek a waiver under Section 1115 of the Social
Security Act (42 U.S.C. Section 1315) to the state Medicaid plan to
expand the categories of individuals eligible for Medicaid benefits
by allowing the county to provide Medicaid benefits to any resident
(1)  who is not otherwise eligible to receive Medicaid
benefits under the program established under Chapter 32, Human
Resources Code, and operated by this state, including through a
waiver, other than a waiver sought under this section, to the
(2)  who applies to receive Medicaid benefits; and
(3)  for whom federal matching funds are available
under the Patient Protection and Affordable Care Act (Pub. L.
No. 111-148) as amended by the Health Care and Education
Reconciliation Act of 2010 (Pub. L. No. 111-152) to provide
(b)  The terms of a waiver under this section must:
(1)  specify how, and with the assistance of what
entities, the county will implement and operate a delivery system
for the provision of Medicaid benefits to individuals described by
(2)  specify the commission's role in facilitating the
provision of those Medicaid benefits;
(3)  identify the sources of money to be used to pay
this state's share of the cost of Medicaid benefits the county
(4)  establish qualifications for an individual to be
considered a resident of the county for purposes of receiving
Medicaid benefits from the county; and
(5)  if appropriate, prescribe changes to the
commission's eligibility determination process for Medicaid
benefits to accommodate the expanded categories of individuals
eligible to receive Medicaid benefits from the county.
(c)  The executive commissioner shall adopt rules necessary
SECTION 2.  Not later than December 1, 2025, the executive
commissioner of the Health and Human Services Commission shall
adopt rules necessary to implement Section 540.0002, Government
Code, as added by this Act, including rules that specify procedures
by which a county may request that the executive commissioner seek a
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.