All Roll Calls
Yes: 539 • No: 39
TexasHB 2689th Legislature Regular SessionHouseWALLET
Relating to authorizing Medicaid managed care organizations to offer nutrition support services in lieu of other state Medicaid plan services.
Sponsored By: James Frank, Lacey Hull, Carrie Isaac, Lois Kolkhorst (Republican), Christian Manuel, Toni Rose
Signed by Governor
Human Services--Medical AssistanceMental Health & Substance AbuseMEDICAIDNUTRITIONPREGNANCY & CHILDBIRTHHEALTH & HUMAN SERVICES COMMISSION
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Medicaid Nutrition Pilot for High-Risk Pregnancies
Beginning September 1, 2025, Texas has authority—but no duty—to start a Medicaid managed-care nutrition pilot. It serves pregnant recipients diagnosed with chronic conditions that may cause high-risk pregnancies or birth complications. Examples include gestational diabetes, high blood pressure, and obesity. Plans can substitute counseling, medically tailored meals, and other state-approved, evidence-based nutrition support for regular Medicaid services. Meals must come with nutrition counseling and instruction. Texas must track service use and adherence, pregnancy outcomes, effects on chronic-condition symptoms, and newborn and infant health. The pilot ends August 31, 2030, followed by a report to lawmakers on outcomes and recommended actions. The law authorizing the pilot expires September 1, 2031. The contract timing and federal approval rules also apply to this pilot.
More Nutrition Counseling Options Through Medicaid
Texas Medicaid managed-care plans can offer approved nutrition counseling and instruction instead of other covered services. Recipients do not have to use these substitutes. Services must be medically appropriate, cost-effective, backed by evidence, and listed in contracts with state advisory committee approval. This nutrition list cannot include home-delivered meals, food prescriptions, or grocery support. Texas must report service use yearly and consider actual costs and use when setting payments to plans. The changes apply to contracts entered into or renewed starting September 1, 2025; older contracts remain under prior law. State agencies can delay provisions needing federal approval until approval is granted.
Sponsors & Cosponsors
Sponsors
James Frank
House
Lacey Hull
House
Carrie Isaac
House
Lois Kolkhorst
Republican • Senate
Christian Manuel
House
Toni Rose
House
Cosponsors
César Blanco
Democratic • Senate
Aicha Davis
House
Lulu Flores
House
Jolanda "Jo" Jones
House
Suleman Lalani
House
Mihaela Plesa
House
Joanne Shofner
House
Roll Call Votes
House vote • 5/29/2025
Record vote
Yes: 130 • No: 9
Senate vote • 5/26/2025
Record vote
Yes: 0 • No: 0
Senate vote • 5/26/2025
Record vote
Yes: 0 • No: 0
House vote • 4/23/2025
Record vote
Yes: 132 • No: 13
House vote • 4/22/2025
Record vote
Yes: 138 • No: 9
House vote • 4/22/2025
Record vote
Yes: 139 • No: 8
Bill Text
Engrossed
Enrolled
House Committee Report
Introduced
Senate Committee Report
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