Texas 2009 - 81st Regular

Texas House Bill HB2388 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	81R5578 ALB-D
2	2	By: Hernandez H.B. No. 2388
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the child health plan program.
8	8	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9	9	SECTION 1. Section 62.002(2), Health and Safety Code, is
10	10	amended to read as follows:
11	11	(2) "Executive commissioner" or "commissioner
12	12	[Commissioner]" means the executive commissioner of the Health
13	13	[health] and Human Services Commission [human services].
14	14	SECTION 2. Section 62.101(b), Health and Safety Code, is
15	15	amended to read as follows:
16	16	(b) The commission shall establish income eligibility
17	17	levels consistent with Title XXI, Social Security Act (42 U.S.C.
18	18	Section 1397aa et seq.), as amended, and any other applicable law or
19	19	regulations, and subject to the availability of appropriated money,
20	20	so that a child who is younger than 19 years of age and whose net
21	21	family income is at or below 300 [200] percent of the federal
22	22	poverty level is eligible for health benefits coverage under the
23	23	program. In addition, the commission may establish eligibility
24	24	standards regarding the amount and types of allowable assets for a
25	25	family whose net family income is above 250 [150] percent of the
26	26	federal poverty level.
27	27	SECTION 3. Sections 62.102(b) and (c), Health and Safety
28	28	Code, are amended to read as follows:
29	29	(b) During the sixth month following the date of initial
30	30	enrollment or reenrollment of an individual whose net family income
31	31	exceeds 285 [185] percent of the federal poverty level, the
32	32	commission shall:
33	33	(1) review the individual's net family income and may
34	34	use electronic technology if available and appropriate; and
35	35	(2) continue to provide coverage if the individual's
36	36	net family income does not exceed the income eligibility limits
37	37	prescribed by Section 62.101 [this chapter].
38	38	(c) If, during the review required under Subsection (b), the
39	39	commission determines that the individual's net family income
40	40	exceeds the income eligibility limits prescribed by Section 62.101
41	41	[this chapter], the commission may not disenroll the individual
42	42	until:
43	43	(1) the commission has provided the family an
44	44	opportunity to demonstrate that the family's net family income is
45	45	within the income eligibility limits prescribed by Section 62.101
46	46	[this chapter]; and
47	47	(2) the family fails to demonstrate such eligibility.
48	48	SECTION 4. Section 62.153, Health and Safety Code, is
49	49	amended by amending Subsection (a) and adding Subsection (a-1) to
50	50	read as follows:
51	51	(a) To the extent permitted under 42 U.S.C. Section 1397cc,
52	52	as amended, and any other applicable law or regulations, the
53	53	commission shall require enrollees whose net family incomes are at
54	54	or below 200 percent of the federal poverty level to share the cost
55	55	of the child health plan, including provisions requiring enrollees
56	56	under the child health plan to pay:
57	57	(1) a copayment for services provided under the plan;
58	58	(2) an enrollment fee; or
59	59	(3) a portion of the plan premium.
60	60	(a-1) The commission shall require enrollees whose net
61	61	family incomes are greater than 200 percent but not greater than 300
62	62	percent of the federal poverty level to pay a share of the cost of
63	63	the child health plan through copayments, fees, and a portion of the
64	64	plan premium. The amount of the share required to be paid must:
65	65	(1) exceed the amount required to be paid by enrollees
66	66	described by Subsection (a); and
67	67	(2) equal the highest amount that may be required to be
68	68	paid under federal law, but not to exceed five percent of the
69	69	enrollee's net family income.
70	70	SECTION 5. Chapter 62, Health and Safety Code, is amended by
71	71	adding Subchapter F to read as follows:
72	72	SUBCHAPTER F. BUY-IN OPTION
73	73	Sec. 62.251. BUY-IN OPTION FOR CERTAIN CHILDREN. The
74	74	executive commissioner shall develop and implement a buy-in option
75	75	in accordance with this subchapter under which children whose net
76	76	family incomes exceed 300 percent of the federal poverty level are
77	77	eligible to purchase health benefits coverage available under the
78	78	child health plan program.
79	79	Sec. 62.252. RULES; ELIGIBILITY AND COST-SHARING. (a) The
80	80	executive commissioner shall adopt rules in accordance with federal
81	81	law that apply to a child for whom health benefits coverage is
82	82	purchased under this subchapter. The rules must:
83	83	(1) establish eligibility requirements;
84	84	(2) require payment of 100 percent of the health
85	85	benefits plan premium and additional deductibles, coinsurance, or
86	86	other cost-sharing payments as determined by the executive
87	87	commissioner; and
88	88	(3) provide for a waiting period.
89	89	(b) Notwithstanding any other provision of this chapter,
90	90	the executive commissioner may establish rules and procedures for
91	91	children for whom health benefits coverage is purchased under this
92	92	subchapter that differ from the rules and procedures generally
93	93	applicable to the child health plan program.
94	94	Sec. 62.253. CROWD-OUT. To the extent allowed by federal
95	95	law, the buy-in option developed under this subchapter must include
96	96	provisions designed to discourage:
97	97	(1) employers and other persons from electing to
98	98	discontinue offering health benefits plan coverage for employees'
99	99	children under employee or other group health benefits plans; and
100	100	(2) individuals with access to adequate health
101	101	benefits plan coverage for their children from electing not to
102	102	obtain, or to discontinue, that coverage.
103	103	SECTION 6. Not later than January 1, 2010, the executive
104	104	commissioner of the Health and Human Services Commission shall
105	105	adopt rules as necessary to implement Subchapter F, Chapter 62,
106	106	Health and Safety Code, as added by this Act.
107	107	SECTION 7. If before implementing any provision of this Act
108	108	a state agency determines that a waiver or authorization from a
109	109	federal agency is necessary for implementation of that provision,
110	110	the agency affected by the provision shall request the waiver or
111	111	authorization and may delay implementing that provision until the
112	112	waiver or authorization is granted.
113	113	SECTION 8. This Act takes effect September 1, 2009.