Texas Medicaid

Texas Medicaid is more than just health care—it is an investment in the future of Texas. It goes beyond the doctor’s office and into our schools, our workplaces and our communities.

Featured Resources

Who Is Texas Medicaid?

The Managed Care Solution

How Does Texas Medicaid Managed Care Work?

Closing the Gaps: Medicaid Mental Health Coverage

Support SB 999: A Practical Fix for Medicaid Eligibility Delays

Additional Resources

All

Policy Papers

TAHP Presentations

101s

Testimonies

Comment Letters

Legislative Briefs

News

TAHP Announces Texas Covered 2025 Agenda

Presentation: Why Texas Stands to Lose Without Enhanced Tax Credits

Keeping Health Care Affordable: Renewing Enhanced Tax Credits One-Pager

TAHP’s Summary of HHSC’s Self-Evaluation Report

7.24.25 VDP MCO Pharmacy Meeting Recap

2025.07.16 Medicaid Rate Hearing: Attendant Services in CLASS, CFC, DAHS, DBMD, PHC, CAS, FC, RC, STAR Kids and STAR Health MDCP, STAR Kids and STAR Health state plan services, and STAR PLUS HCBS and Non-HCBS programs, Effective 9/1/25

2025.07.22 Medicaid Rate Hearing: Maternal Fetal Medicine Radiological Services, Applied Behavior Analysis Services, Dental Reimbursement, and Rural Hospitals, Effective 9/1/25

2025.07.16 Medicaid Rate Hearing: NF and Nursing Facility Special Reimbursement Class for Individuals with IDDs, Effective 9/1/25

2025.07.16 Medicaid Rate Hearing: Attendant Services in CFC, HCBS-AMH, HCS, TxHmL, and ICF/IID Programs, Effective 9/1/25

2025.04.30 Testimony in Opposition to SB 2450 (Medicaid Vision Mandate)

2025.04.08 Testimony on HB 3151 (Expedited Credentialing for FQHCs)

2025.04.08 Testimony on SB 2458 (Medicaid RAC Expansion)

2025.04.09 Testimony Opposing HB 3812 (TMB Prior Authorization Overreach)

2025.03.12 TAHP Testimony in Support of SB 963 (MCO Private Coverage Outreach)

Texas Must Reject Costly ERISA Mandates Like SB 1122

Support SB 999: A Practical Fix for Medicaid Eligibility Delays

89th Session Agenda and Health Coverage 101 – Food for Thought Presentation

Transparency in Health Care Mandates: New Legislation Offers Relief for Texas Businesses and Families

Provider Credentialing 101

2024.09.18 Medicaid Mental Health Testimony for Senate Health & Human Services

Medicaid Rx 101

Medicaid 101

Medicaid Drug Coverage Works

2024.07.31 Youth Health & Safety Select Committee Presentation

Food for Thought Presentation: Medicaid Mental Health Coverage

Medicaid Drug Coverage 101

Psychiatric Residential Youth Treatment Facility (PRYTF) Rules Comments

Closing the Gaps: Medicaid Mental Health Coverage

CPW Credentialing Provider Resource

Texas Medicaid Managed Care Continues to Deliver on Savings & Outcomes

Texas Families Struggle as Medicaid Falls Short on Mental Health Care

4 Things You Didn’t Know About Texas Medicaid

Food for Thought Presentation: Medicaid 101

How Does Texas Medicaid Managed Care Work?

Who Is Texas Medicaid?

A Critical Gap: The Need for Stronger Health Care Fraud and Abuse Protections in Texas

Texas Extends Medicaid Coverage for New Moms on March 1st

Texting Helps Medicaid Plans Provide Better Care

Medicaid Monday: The Unwinding Has Begun

New Poll: Texas Voters Support a Strong Medicaid Program

Medicaid Monday: Service Coordinators Connect Members to Services

Medicaid Monday: Mental Health Innovations in Managed Care

Medicaid Monday: Managed Care Means Innovation

Medicaid Monday: Managed Care Reduces ER Visits

Medicaid Monday: Medicaid Managed Care Nurses Make a Difference

Medicaid Monday: New Moms Still High-Risk for Medicaid Churn

Texas Medicaid Managed Care is Working to Keep People Covered Even after the PHE

Jessica Lynch Joins TAHP As Director of Policy, Government Program

What Drives Healthy Outcomes?

Texas Invests Federal Funds in IT for Better Health Care

Medicaid Monday: 56 Years of Medicaid

Texas Covered Conference + Expo Agenda Release

Medicaid Monday: STAR Kids Program Beats National Benchmark

Medicaid Monday: Legislative Update

Medicaid Monday: Improving Client Communication

Medicaid Monday: Care Coordination Creates Better Outcomes and Savings

Medicaid Monday: Medicaid Managed Care Works

Medicaid Monday: Texas Medicaid MCOs Save Money on Prescription Drugs for Taxpayers

New Partnership with Texas Medicare Advantage Plans to Help “Save our Seniors”

Medicaid Monday: Texas Medicaid MCOs Increase Access to Care

HB 4 and SB 412 Provide Smart Telehealth Expansion

TAHP Announces Medicaid Priorities for the 2021 Legislative Session

Connecting Texans: Texas Medicaid Managed Care Plans Support Texans During COVID-19

Texas Medicaid Serves Texas Veterans

Texas Medicaid Managed Care Plans Bring out the Best of the Texas Medicaid Program

Finding Health Coverage When You Lose Your Job: COBRA Is Not Your Only Option

TAHP Joins New Learning Collaborative

TribTalk: Medicaid Managed Care is Still the Right Choice for Texas

TAHP Urges TX US Senators to Reauthorize CHIP

HHSC Releases 2017 Fact Book

Legislators File Bill Extending Sunset Date of State-Run Medicaid Formulary

TAHP Recommends HHSC Request Funding for Mental Health in 2026-27 LAR

TAHP Recommends Medicaid Cost Containment Initiatives to HHSC

TAHP Comments on Incomplete Prior Authorization Rules

TAHP Comments on Proposed Rule Amendments Concerning the eHAC Extension

TAHP Comments on Proposed Chemical Dependency Rule

TAHP’s Comments to HHSC on Outpatient Hospital Reimbursement Methodology

One Pager Supporting HB 3286: Patient Protections in Medicaid Rx

Testimony Supporting HB 3286: PDL Exceptions

One Pager Supporting HB 2802: MCO Texting

Testimony Supporting HB 2802: MCO Texting

One-Pager Opposing HB 4823: Undermines Managed Care

Testimony On SB 1113: PDL Carve-Out

One-Pager Opposing HB 1293: Mandating Fee-for-Service Pharmacy Rates in Medicaid Managed Care

Testimony Opposing HB 1293: National Average Drug Acquisition Cost

Testimony Opposing HB 5274: Expedited Credentialing

Testimony Opposing HB 5018: EVV Claims

Testimony Opposing HB 3891: RAC

Testimony Supporting SB 1695: Case Assistance Affiliates

Testimony Opposing SB 1138: White Bagging & Hospital Drug Markups

Testimony Opposing HB 5023: MCO Profits Used for Provider Bonuses

One-Pager Opposing HB 3985: MDCP Private Coverage

Testimony Opposing HB 1283: PDL Outside of Managed care

Testimony Supporting HB 3286: PDL

One-Pager Supporting HB 3571/SB 1695: Medicaid CAA

Testimony Supporting HB 2802: Medicaid Texting

Behavioral Health Funding

Coalition Letter Supporting HB 12: Extend Medicaid Postpartum Coverage to 12 Months

Testimony Opposing HB 916: 12-Month Contraceptive Mandate

Testimony Supporting HB 12: Medicaid 12-Month Postpartum Coverage

TAHP Comments to Proposed HB 4 Rules

The Prescription for a Healthier Texas Medicaid

Learn More About Health Coverage

Medicaid 101

Keeping Health Care Affordable: Renewing Enhanced Tax Credits One-Pager

TAHP’s Summary of HHSC’s Self-Evaluation Report

2025.07.16 Medicaid Rate Hearing: Attendant Services in CLASS, CFC, DAHS, DBMD, PHC, CAS, FC, RC, STAR Kids and STAR Health MDCP, STAR Kids and STAR Health state plan services, and STAR PLUS HCBS and Non-HCBS programs, Effective 9/1/25

2025.07.22 Medicaid Rate Hearing: Maternal Fetal Medicine Radiological Services, Applied Behavior Analysis Services, Dental Reimbursement, and Rural Hospitals, Effective 9/1/25

2025.07.16 Medicaid Rate Hearing: NF and Nursing Facility Special Reimbursement Class for Individuals with IDDs, Effective 9/1/25

2025.07.16 Medicaid Rate Hearing: Attendant Services in CFC, HCBS-AMH, HCS, TxHmL, and ICF/IID Programs, Effective 9/1/25

Support SB 999: A Practical Fix for Medicaid Eligibility Delays

Medicaid Drug Coverage Works

Closing the Gaps: Medicaid Mental Health Coverage

CPW Credentialing Provider Resource

How Does Texas Medicaid Managed Care Work?

Who Is Texas Medicaid?

Testimony Supporting HB 2802: MCO Texting

Coalition Letter Supporting HB 12: Extend Medicaid Postpartum Coverage to 12 Months

The Prescription for a Healthier Texas Medicaid

Learn More About Health Coverage

Presentation: Why Texas Stands to Lose Without Enhanced Tax Credits

89th Session Agenda and Health Coverage 101 – Food for Thought Presentation

Provider Credentialing 101

2024.07.31 Youth Health & Safety Select Committee Presentation

Food for Thought Presentation: Medicaid Mental Health Coverage

Medicaid Drug Coverage 101

Food for Thought Presentation: Medicaid 101

Behavioral Health Funding

Medicaid Rx 101

Medicaid 101

Medicaid 101

2025.04.30 Testimony in Opposition to SB 2450 (Medicaid Vision Mandate)

2025.04.08 Testimony on HB 3151 (Expedited Credentialing for FQHCs)

2025.04.08 Testimony on SB 2458 (Medicaid RAC Expansion)

2025.04.09 Testimony Opposing HB 3812 (TMB Prior Authorization Overreach)

2025.03.12 TAHP Testimony in Support of SB 963 (MCO Private Coverage Outreach)

2024.09.18 Medicaid Mental Health Testimony for Senate Health & Human Services

Testimony Supporting HB 3286: PDL Exceptions

Testimony On SB 1113: PDL Carve-Out

Testimony Opposing HB 1293: National Average Drug Acquisition Cost

Testimony Opposing HB 5274: Expedited Credentialing

Testimony Opposing HB 5018: EVV Claims

Testimony Opposing HB 3891: RAC

Testimony Supporting SB 1695: Case Assistance Affiliates

Testimony Opposing SB 1138: White Bagging & Hospital Drug Markups

Testimony Opposing HB 5023: MCO Profits Used for Provider Bonuses

Testimony Opposing HB 1283: PDL Outside of Managed care

Testimony Supporting HB 3286: PDL

Testimony Supporting HB 2802: Medicaid Texting

Testimony Opposing HB 916: 12-Month Contraceptive Mandate

Testimony Supporting HB 12: Medicaid 12-Month Postpartum Coverage

TAHP Recommends HHSC Request Funding for Mental Health in 2026-27 LAR

TAHP Recommends Medicaid Cost Containment Initiatives to HHSC

TAHP Comments on Incomplete Prior Authorization Rules

TAHP Comments on Proposed Rule Amendments Concerning the eHAC Extension

TAHP Comments on Proposed Chemical Dependency Rule

TAHP’s Comments to HHSC on Outpatient Hospital Reimbursement Methodology

TAHP Comments to Proposed HB 4 Rules

Psychiatric Residential Youth Treatment Facility (PRYTF) Rules Comments

One Pager Supporting HB 3286: Patient Protections in Medicaid Rx

One Pager Supporting HB 2802: MCO Texting

One-Pager Opposing HB 4823: Undermines Managed Care

One-Pager Opposing HB 1293: Mandating Fee-for-Service Pharmacy Rates in Medicaid Managed Care

One-Pager Opposing HB 3985: MDCP Private Coverage

One-Pager Supporting HB 3571/SB 1695: Medicaid CAA

TAHP Announces Texas Covered 2025 Agenda

Texas Must Reject Costly ERISA Mandates Like SB 1122

Transparency in Health Care Mandates: New Legislation Offers Relief for Texas Businesses and Families

Texas Medicaid Managed Care Continues to Deliver on Savings & Outcomes

Texas Families Struggle as Medicaid Falls Short on Mental Health Care

4 Things You Didn’t Know About Texas Medicaid

A Critical Gap: The Need for Stronger Health Care Fraud and Abuse Protections in Texas

Texas Extends Medicaid Coverage for New Moms on March 1st

Texting Helps Medicaid Plans Provide Better Care

Medicaid Monday: The Unwinding Has Begun

New Poll: Texas Voters Support a Strong Medicaid Program

Medicaid Monday: Service Coordinators Connect Members to Services

Medicaid Monday: Mental Health Innovations in Managed Care

Medicaid Monday: Managed Care Means Innovation

Medicaid Monday: Managed Care Reduces ER Visits

Medicaid Monday: Medicaid Managed Care Nurses Make a Difference

Medicaid Monday: New Moms Still High-Risk for Medicaid Churn

Texas Medicaid Managed Care is Working to Keep People Covered Even after the PHE

Jessica Lynch Joins TAHP As Director of Policy, Government Program

What Drives Healthy Outcomes?

Texas Invests Federal Funds in IT for Better Health Care

Medicaid Monday: 56 Years of Medicaid

Texas Covered Conference + Expo Agenda Release

Medicaid Monday: STAR Kids Program Beats National Benchmark

Medicaid Monday: Legislative Update

Medicaid Monday: Improving Client Communication

Medicaid Monday: Care Coordination Creates Better Outcomes and Savings

Medicaid Monday: Medicaid Managed Care Works

Medicaid Monday: Texas Medicaid MCOs Save Money on Prescription Drugs for Taxpayers

New Partnership with Texas Medicare Advantage Plans to Help “Save our Seniors”

Medicaid Monday: Texas Medicaid MCOs Increase Access to Care

HB 4 and SB 412 Provide Smart Telehealth Expansion

TAHP Announces Medicaid Priorities for the 2021 Legislative Session

Connecting Texans: Texas Medicaid Managed Care Plans Support Texans During COVID-19

Texas Medicaid Serves Texas Veterans

Texas Medicaid Managed Care Plans Bring out the Best of the Texas Medicaid Program

Finding Health Coverage When You Lose Your Job: COBRA Is Not Your Only Option

TAHP Joins New Learning Collaborative

TribTalk: Medicaid Managed Care is Still the Right Choice for Texas

TAHP Urges TX US Senators to Reauthorize CHIP

HHSC Releases 2017 Fact Book

Legislators File Bill Extending Sunset Date of State-Run Medicaid Formulary

Become a Member Today

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Membership with TAHP is an invaluable tool for integrating, building relationships, exchanging information and best practices, and promoting your services. You will be well-armed with the most timely and accurate information, strong relationships with key Texas leaders, and access to seasoned policy and regulatory experts.

1. How can I enroll in a health insurance plan during open enrollment?
Open enrollment for health insurance typically occurs annually from November 1 to December 15. During this period, you can enroll in or make changes to your health insurance plan through the Health Insurance Marketplace at HealthCare.gov. If you miss this window, you may qualify for a Special Enrollment Period due to certain life events, such as marriage, birth of a child, or loss of other coverage.

2. What are the health insurance options available in Texas?
Texans have several health insurance options, including:
  • Employer-Sponsored Insurance: Coverage provided by your employer.
  • Individual Plans: Purchased directly from insurance companies or through the Health Insurance Marketplace.
  • Government Programs: Such as Medicaid, the Children's Health Insurance Program (CHIP), and Medicare.
  • Short-Term Plans: Temporary coverage for specific periods.

3. Who is eligible for Medicaid and CHIP in Texas?
Medicaid: Available to low-income individuals, families, pregnant women, the elderly, and people with disabilities. Eligibility is based on income and household size.
CHIP: Provides health coverage for children in families that earn too much to qualify for Medicaid but cannot afford private insurance.
For detailed eligibility criteria, visit the Texas Health and Human Services website.

4. What is the Health Insurance Marketplace, and how does it work in Texas?
The Health Insurance Marketplace is a platform where individuals can compare and purchase health insurance plans. In Texas, the federal government operates the Marketplace through HealthCare.gov. You can compare plans, check for subsidies, and enroll during the open enrollment period.

5. Are there financial assistance options to help pay for health insurance?
Yes, depending on your income and household size, you may qualify for subsidies to lower your premiums and out-of-pocket costs. These include:
  • Premium Tax Credits: Reduce the amount you pay for insurance premiums.
  • Cost-Sharing Reductions: Lower your out-of-pocket costs for deductibles, copayments, and coinsurance.
Eligibility for these subsidies is determined through the Health Insurance Marketplace.

6. What should I consider when choosing a health insurance plan?
Consider these factors:
  • Premiums
  • Deductibles
  • Network of doctors and hospitals
  • Coverage of required medications and services
  • Out-of-Pocket Maximum
For more guidance, refer to the Texas Department of Insurance's Health Plan Shopping Guide.

7. What is a Special Enrollment Period, and how can I qualify?
A Special Enrollment Period (SEP) allows you to enroll in health insurance outside the annual open enrollment period if you experience certain life events:
  • Loss of Health Coverage
  • Household Changes (e.g. marriage, divorce, birth)
  • Residence Changes
To apply, visit HealthCare.gov.

8. How can I find out if my doctor is covered under a specific health plan?
Most insurance companies provide online directories of in-network providers. You can also contact the insurer directly or ask your doctor’s office to verify coverage.

9. Where can I get assistance with understanding and enrolling in health insurance?
Several resources are available: