Texas Medicaid Program Overview

Enrollment, funding, and managed care facts for Texas Medicaid.

Get Texas's Medicaid Fee Schedule →
4.14-4.20M
Enrolled
Not Expanded
ACA expansion status
59.83%
Federal match (FMAP), FFY2026
93.3-97%
In managed care

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.

Frequently Asked Questions

No. Texas has not adopted full Medicaid expansion under the Affordable Care Act as of 2026.

Get Texas's Free Medicaid Fee Schedule

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