Texas Constitutional Amendment on Medicaid Expansion

HJR 40 is a proposal from the Texas Legislature to expand health insurance coverage in our state. It would change the Texas Constitution to require Medicaid eligibility for all individuals who qualify under federal law. The Patient Protection and Affordable Care Act (also called the ACA) already provides federal matching funds for this expansion—money our state could use right now.

Currently, Texas has stricter limits on who can get Medicaid than federal law allows. This proposal would align our state rules with federal standards. If approved by voters, the new rule would take effect January 1, 2026. The change would mean more low-income Texans could access health insurance without state budget increases, since federal dollars already cover the cost.

The proposal was introduced by State Representative Ron Reynolds. Texas voters will make the final decision on November 4, 2025. The ballot question will ask voters whether to approve expanding Medicaid eligibility to all individuals for whom federal matching funds are available under the Affordable Care Act.

This is a chance for our community to decide whether to bring available federal resources into Texas healthcare. Expanding Medicaid would help more people afford medical care, preventive services, and prescription medications.

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