Some of the bill’s changes go into effect later this year, while others won’t start until after the midterms in 2026.

Specific changes to SNAP and Medicaid — and other provisions in the bill — could have significant impacts in Texas.

The bill introduces a Medicaid work requirement, higher out-of-pocket costs and limits retroactive coverage. It also restricts Medicaid eligibility for some noncitizens, including refugees. U.S. President Donald Trump’s massive tax cut and spending bill could end Medicaid coverage for 310,