Low-income Texans could get help buying private health coverage if Texas gains federal approval
What it does
HB 1089 would set up a risk-based Medicaid program, but Texas would operate it only if the federal government authorized a block grant or another type of waiver. Under the proposal, acute care eligibility would include people with household income at or below 100% of the federal poverty level, people younger than 19 who receive SSI or live in certain state foster care settings, and people who qualified under state rules on August 31, 2027. Eligible people could get sliding-scale help with private health plan premiums and cost sharing, while a separate program would help some residents under age 65 with income at or below 133% of the poverty level buy private coverage if they do not otherwise qualify for Medicaid. The private-market program would depend on federal approval and would not guarantee assistance with obtaining coverage.
What it means for your community
Some Medicaid-eligible residents could receive help buying a private health plan, but they could still owe the difference between the premium and their subsidy, plus any copays not covered by extra help. Residents who do not otherwise qualify for Medicaid, including some people under 65 with household income at or below 133% of the poverty level, could be connected to private coverage options, but the bill says this help is not guaranteed. Any federal agreement would have to make the private-market program cost neutral to Texas through premium tax revenue and savings, with goals that include reducing general revenue health care costs and easing local tax burdens. State officials would also develop a plan for long-term services that supports consumer choice and reduces reliance on institutions, while encouraging family cost sharing when appropriate.
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