Relating to the expansion of eligibility for Medicaid to certain individuals under the federal Patient Protection and Affordable Care Act.

SB 638 requires Texas to expand Medicaid eligibility under the federal Affordable Care Act, directly affecting low-income adults who currently qualify under federal guidelines but are excluded by Texas' existing eligibility limits. The bill mandates that the state provide medical assistance to all eligible applicants using available federal matching funds, overriding previous restrictions. It also requires annual reports tracking impacts on uninsured rates, state/local healthcare costs, and hospital charity care. The law takes effect September 1, 2025, applying to new applications and recertifications after that date.