Texas Medicaid Program Overview
Enrollment, funding, and managed care facts for Texas Medicaid.
Get Texas's Medicaid Fee Schedule →Enrollment
Texas Medicaid covered approximately 4.14-4.20M people. Two independent sources give close but not identical 2024 figures for total Texas Medicaid enrollment: KFF's state indicator (4,204,878, May 2024) and CMS's own 2024 Medicaid Managed Care Enrollment and Program Characteristics report (4,141,972 total Medicaid enrollees). Reported as a range rather than a single false-precision number.
Funding & federal match
Texas has not adopted ACA Medicaid expansion.
For FFY2026 (Oct 1, 2025 - Sep 30, 2026), Texas's Federal Medical Assistance Percentage (FMAP) is 59.83%.
Delivery system & managed care
A large share of Texas Medicaid is delivered through managed care organizations (MCOs) rather than fee-for-service — estimates range from 93.3-97% of Medicaid enrollees.
Waivers
Texas operates Medicaid managed care under the Texas Healthcare Transformation and Quality Improvement Program, a Section 1115 demonstration waiver. Provides federal authority for most of Texas's Medicaid managed care programs (STAR, STAR+PLUS, STAR Kids, Children's Dental Program). Federally approved through September 30, 2030.
Has Texas expanded Medicaid under the ACA?
No. Texas has not adopted full Medicaid expansion under the Affordable Care Act as of 2026.
How many people are enrolled in Texas Medicaid?
Approximately 4.14-4.20M people.
What percentage of the federal Medicaid match does Texas receive?
59.83% for FFY2026 (Oct 1, 2025 - Sep 30, 2026) — meaning the federal government pays roughly 60 cents of every Texas Medicaid dollar, and the state pays the rest.
Is most of Texas Medicaid delivered through managed care?
Estimates range from 93.3-97% of Medicaid enrollees in managed care.
What Medicaid waivers does Texas operate under?
Texas Healthcare Transformation and Quality Improvement Program, a Section 1115 demonstration waiver. Provides federal authority for most of Texas's Medicaid managed care programs (STAR, STAR+PLUS, STAR Kids, Children's Dental Program). Federally approved through September 30, 2030.
Get Texas's Free Medicaid Fee Schedule
Request actual Texas Medicaid reimbursement rates by billing code — free, delivered as a CSV.
Sources
- KFF State Health Facts - Total Monthly Medicaid & CHIP Enrollment
- CMS - Medicaid Managed Care Enrollment and Program Characteristics, 2024
- Federal Register - FY2026 FMAP Notice
- TMHP - FMAP and EFMAP to Change on October 1, 2025
- KFF - Status of State Medicaid Expansion Decisions
- healthinsurance.org - Medicaid eligibility and enrollment in Texas
- Texas HHSC - Texas Medicaid and CHIP Reference Guide, 15th Edition
- Texas HHS - Medicaid 1115 Waiver Overview
- Medicaid.gov - Section 1115 Demonstrations, Texas Healthcare Transformation and Quality Improvement Program
Data last verified 2026-09-17. Also see our free Medicaid Fee Schedule tool.