HB 426 – Medicaid Expansion

HB 426 mandates new Medicaid and CHIP coverage for custom helmets used to treat certain head shape conditions in infants, regardless of whether insurers or doctors deem them medically necessary or cosmetic. While well-intentioned, this bill imposes a costly expansion of government healthcare obligations, with more than $5 million in new annual spending by 2030. The legislation creates a precedent for adding condition-specific benefits that may not be essential or cost-effective, opening the floodgates for other narrowly tailored mandates. The bill increases state spending without structural reforms or demonstrated long-term savings. Medicaid is already one of the fastest-growing items in the Texas budget. Fiscally conservative policy should prioritize flexibility and restraint over rigid mandates that tie the state’s hands. With no meaningful cap on utilization or cost, HB 426 risks growing the Medicaid bureaucracy and creating inefficiencies