Bill > HB5311

This bill establishes the Texas Care Plan Medicaid buy-in program, which would allow Texas residents to purchase health coverage through Medicaid by enrolling in a managed care plan. The program requires the executive commissioner to seek a federal waiver and develop eligibility requirements, including household income limits and restrictions on participants who already have other health coverage. Participants would pay premiums on a sliding scale based on their income, following federal cost-sharing reduction guidelines. The program aims to leverage enhanced federal funding from the Affordable Care Act and will be designed to be similar to existing Medicaid buy-in programs, with some variations to accommodate the specific population served. The program will differ slightly from existing Medicaid buy-in programs, notably by not requiring non-emergency transportation services. The Health and Human Services Commission is directed to apply for the necessary federal waiver and may delay implementation until the waiver is granted. The bill would take effect immediately if it receives a two-thirds vote in the Texas legislature, or on September 1, 2025, if it does not receive the immediate vote threshold.

Budget and Finance

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB5311