81R5011 KFF-D
By: Dukes H.B. No. 743
A BILL TO BE ENTITLED
AN ACT
relating to health benefits coverage for certain persons under the
child health plan and other programs.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 62.101(b), Health and Safety Code, is
amended to read as follows:
(b) The commission shall establish income eligibility
levels consistent with Title XXI, Social Security Act (42 U.S.C.
Section 1397aa et seq.), as amended, and any other applicable law or
regulations, and subject to the availability of appropriated money,
so that a child who is younger than 19 years of age and whose net
family income is at or below 300 [200] percent of the federal
poverty level is eligible for health benefits coverage under the
program. In addition, the commission may establish eligibility
standards regarding the amount and types of allowable assets for a
family whose net family income is above 150 percent of the federal
poverty level.
SECTION 2. Subtitle C, Title 2, Health and Safety Code, is
amended by adding Chapter 65 to read as follows:
CHAPTER 65. DEMONSTRATION PROJECT TO PROVIDE HEALTH BENEFITS PLAN
COVERAGE TO CERTAIN PARENTS
Sec. 65.001. DEFINITIONS. In this chapter:
(1) "Commission" means the Health and Human Services
Commission.
(2) "Executive commissioner" means the executive
commissioner of the Health and Human Services Commission.
Sec. 65.002. NOT AN ENTITLEMENT. This chapter does not
establish an entitlement to assistance in obtaining health
benefits.
Sec. 65.003. HEALTH BENEFITS PLAN COVERAGE FOR CERTAIN
PARENTS. (a) The executive commissioner shall develop and seek a
waiver under Section 1115 of the federal Social Security Act (42
U.S.C. Section 1315) to implement a demonstration project to
provide health benefits plan coverage to an individual who:
(1) is the parent of a child receiving medical
assistance under Chapter 32, Human Resources Code, or of a child
enrolled in the child health plan under Chapter 62;
(2) has a net family income, as defined by Section
62.002, that is equal to or less than 300 percent of the federal
poverty level;
(3) is not eligible for medical assistance; and
(4) is not covered by a health benefits plan offering
adequate benefits, as determined by the commission.
(b) The demonstration project developed under this section
must be designed and administered in a manner that:
(1) qualifies for federal funding; and
(2) is, to the extent practical, substantively
identical to the manner in which the child health plan program is
administered under Chapter 62, except as otherwise provided by this
chapter.
Sec. 65.004. COST-SHARING REQUIREMENTS. The commission
shall require that an individual provided health benefits plan
coverage under this chapter pay:
(1) 100 percent of the plan premium; and
(2) deductibles, coinsurance, or other cost-sharing
payments as determined by the executive commissioner.
Sec. 65.005. BENEFITS COVERAGE REQUIRED. To the extent
possible, a health benefits plan offered under this chapter must
provide benefits similar to the benefits provided under the child
health plan program under Section 62.151.
Sec. 65.006. CROWD-OUT. To the extent allowed by federal
law, the demonstration project under this chapter must include
provisions designed to discourage:
(1) employers and other persons from electing to
discontinue offering health benefits plan coverage for individuals
under employee or other group health benefit plans; and
(2) individuals with access to adequate health benefit
plan coverage, other than coverage under the health benefits plan
offered under this chapter, from electing to not obtain, or to
discontinue, that coverage.
Sec. 65.007. RULES. The executive commissioner shall adopt
rules as necessary to implement the demonstration project under
this chapter.
SECTION 3. Section 62.101(b), Health and Safety Code, as
amended by this Act, applies to a determination of eligibility of a
person for coverage under the child health plan under Chapter 62,
Health and Safety Code, made on or after the effective date of this
Act, regardless of the date the person applied for that coverage.
SECTION 4. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall apply for and actively pursue the waiver
from the federal Centers for Medicare and Medicaid Services or any
other federal agency required by Section 65.003, Health and Safety
Code, as added by this Act. The commission may delay implementing
Chapter 65, Health and Safety Code, as added by this Act, until the
waiver applied for under this section is granted.
SECTION 5. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency, other than the waiver required by Section 65.003,
Health and Safety Code, as added by this Act, is necessary for
implementation of that provision, the agency affected by the
provision shall request the waiver or authorization and may delay
implementing that provision until the waiver or authorization is
granted.
SECTION 6. This Act takes effect September 1, 2009.