Hinojosa, who won the governor's race this fall, has said he wants to use executive authority to extend Medicaid coverage to hundreds of thousands of low-income Texans. But health policy experts and legislative attorneys say that approach would not survive legal scrutiny, because Medicaid expansion requires either an act of the Legislature or a federal waiver approved by the Centers for Medicare and Medicaid Services — neither of which a governor can deliver unilaterally.

Texas is one of ten states that have not expanded Medicaid under the Affordable Care Act, leaving an estimated 1.2 million adults in the coverage gap, according to state health data. Hinojosa campaigned on closing that gap, arguing that expanded coverage would reduce uncompensated care costs for hospitals and improve health outcomes in rural communities.

"The governor-elect is right to prioritize expansion, but the mechanism matters," said a health law scholar at a Texas university who reviewed the proposal. "An executive order cannot rewrite the Social Security Act or the state's Medicaid plan. It would be challenged immediately and almost certainly blocked."

The governor's office did not respond to a request for comment on the legal limits of the plan. A transition spokesperson previously said Hinojosa would "explore every available tool" to expand coverage.

Legislative leaders in both parties have signaled skepticism. The Republican-controlled Senate has repeatedly rejected expansion bills, and some Democrats have questioned whether a unilateral move would poison negotiations. A 2013 proposal to expand Medicaid through a waiver failed in the Legislature after federal officials raised concerns about the state's cost-sharing terms.

Hinojosa's team has pointed to other states where governors used waiver authority to expand coverage, but those expansions were authorized by legislation or approved by voters through ballot measures. In Texas, there is no such authorization.

Advocates for expansion say they will keep pressing the Legislature when it convenes in January. "We need a real plan, not a press release," said a spokesperson for a statewide health advocacy coalition. "That means working with lawmakers to pass a bill and securing federal approval."

For now, the governor-elect's promise remains just that — a promise without a clear legal path. Whether Hinojosa can deliver will depend less on executive will than on the same legislative and federal hurdles that have blocked expansion for more than a decade.