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2025 · Regular session · Senate bill
SB963
SB963 prevents Texas Medicaid managed-care marketing guidelines from banning two kinds of private-plan outreach.
Official caption: Relating to allowing Medicaid managed care organizations to engage in marketing about the availability of certain private health benefit plan coverage.
Official report lists Senate author(s): Hughes. This does not identify sponsors or amendment drafters.
Bill explanation published · Version and amendment review scope is stated below · Individual amendment records may not be separately annotated.
Bill highlights
Selected points from the published explanation. Follow each point to its source-linked context; conditions and limits may matter.
- SB963 prevents Texas Medicaid managed-care marketing guidelines from banning two kinds of private-plan outreach.
- An exchange is the regulated marketplace described in federal rules, including individual and small-employer marketplaces; a qualified health plan has the required exchange-recognized certification.
- The underlying guidelines still address misleading information, misrepresentations, door-to-door recipient marketing, commission-only agents, certain enrollment incentives and face-to-face marketing at public-assistance offices.
- The bill became law without the governor’s signature on June 20, 2025 and took effect September 1, 2025, subject to that provision-specific federal-approval clause.
What does it do?
SB963 prevents Texas Medicaid managed-care marketing guidelines from banning two kinds of private-plan outreach. A Medicaid managed care organization may inform any individual—including current or former Medicaid recipients—about qualified health plans offered through an exchange. It may also advertise a Medicare Advantage plan or related Part C benefit at a community enrollment or other event. This changes permitted communication, not who qualifies for Medicaid, marketplace coverage or Medicare. New section 540.0055(c); Federal exchange and qualified-plan definitions; Medicare Part C eligibility framework.
An exchange is the regulated marketplace described in federal rules, including individual and small-employer marketplaces; a qualified health plan has the required exchange-recognized certification. When an organization provides the qualified-plan information, the state guidelines must require it to also explain potential deductibles, copayments and other cost sharing. The organization or its affiliate may not offer material or financial gain as an actual or implied incentive to enroll in such a plan. That safeguard is about exchange-qualified plans, not a new universal ban on every Medicare-related benefit or advertisement. 45 CFR 155.20; New subsection (d).
The underlying guidelines still address misleading information, misrepresentations, door-to-door recipient marketing, commission-only agents, certain enrollment incentives and face-to-face marketing at public-assistance offices. SB963 does not repeal those provisions or override applicable federal requirements. If an agency determines federal authorization or a waiver is needed for a provision, it must request it and may delay that provision until approval. Existing marketing safeguards; Section 2.
The bill became law without the governor’s signature on June 20, 2025 and took effect September 1, 2025, subject to that provision-specific federal-approval clause. It does not order anyone to switch coverage or guarantee an available plan or subsidy. History; Final act.
What changed along the way?
The introduced bill protected only information to a Medicaid recipient about exchange plans. The Senate substitute expanded the audience to any individual, expressly including current/former recipients, and added Medicare Advantage advertising at events. The sole floor amendment, Manuel’s adopted House third-reading amendment, added the cost-sharing disclosure requirement and material/financial enrollment-incentive prohibition. The Senate concurred, and both safeguards appear in the enrolled law. Disposition; All versions.
For the full amendment record, open the official amendment index.
Official bill versions
Compare the published text versions in the official text index. A change is not attributed to a specific amendment here without a verified record.
Who could benefit—and who could bear the costs?
People seeking other coverage may receive more information from a familiar managed-care organization, including after Medicaid coverage ends. Those receiving exchange-plan information must also be told about potential cost sharing, and the new incentive restriction limits inducements to enroll in those plans. More marketing is not proof that a plan is affordable or suitable; enrollment still depends on the applicable federal rules and individual circumstances. Permissions and safeguards.
The March 10 introduced and March 27 substitute notes anticipated no state or local fiscal implication. After the House safeguards, the April 30 as-passed-House note instead anticipated no significant state/local impact and assumed costs could be absorbed with existing resources. It does not quantify enrollment changes, household savings or marketing costs.
Official sources
- Bill history and latest recorded action
- Bill versions, analyses and fiscal notes
- Action history and votes
- Amendment index
Catalog report retrieved 2026-10-25. Check the official record for corrections or later changes.
