Relating to a "Texas solution" to reforming and addressing issues related to the Medicaid program, including the creation of an alternative program designed to ensure health benefit plan coverage to certain low-income individuals through the private marketplace; requiring a fee.

SB 289 creates a new Texas Medicaid program that shifts health coverage for eligible low-income residents to private health insurance marketplaces instead of the traditional Medicaid system. It sets eligibility for individuals with household income at or below 100% of the federal poverty level, children under 19 in foster care or receiving Supplemental Security Income, or those meeting pre-2025 eligibility standards. The bill requires the state to provide sliding-scale subsidies to help eligible individuals purchase private health plans, with subsidy amounts based on average premiums and the individual's ability to pay, plus additional subsidies for cost-sharing like copayments. The Texas Health and Human Services Commission will administer the program and the bill requires a fee (specific fee details are not provided in the text).