81R2707 ALB-D
By: Naishtat H.B. No. 862
A BILL TO BE ENTITLED
AN ACT
relating to eligibility for the child health plan program.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 62.002(2), Health and Safety Code, is
amended to read as follows:
(2) "Executive commissioner" or "commissioner
[Commissioner]" means the executive commissioner of the Health
[health] and Human Services Commission [human services].
SECTION 2. 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 250 [150] percent of the
federal poverty level.
SECTION 3. Section 62.102(a), Health and Safety Code, is
amended to read as follows:
(a) The [Subject to a review under Subsection (b), the]
commission shall provide that an individual who is determined to be
eligible for coverage under the child health plan remains eligible
for those benefits until the earlier of:
(1) the end of a period not to exceed 12 months,
beginning the first day of the month following the date of the
eligibility determination; or
(2) the individual's 19th birthday.
SECTION 4. Chapter 62, Health and Safety Code, is amended by
adding Subchapter F to read as follows:
SUBCHAPTER F. BUY-IN OPTION
Sec. 62.251. BUY-IN OPTION FOR CERTAIN CHILDREN. The
executive commissioner shall develop and implement a buy-in option
in accordance with this subchapter under which children whose net
family incomes exceed 300 percent of the federal poverty level are
eligible to purchase health benefits coverage available under the
child health plan program.
Sec. 62.252. RULES; ELIGIBILITY AND COST-SHARING. (a) The
executive commissioner shall adopt rules in accordance with federal
law that apply to a child for whom health benefits coverage is
purchased under this subchapter. The rules must:
(1) establish eligibility requirements;
(2) require payment of 100 percent of the health
benefits plan premium and additional deductibles, coinsurance, or
other cost-sharing payments as determined by the executive
commissioner; and
(3) provide for a waiting period.
(b) Notwithstanding any other provision of this chapter,
the executive commissioner may establish rules and procedures for
children for whom health benefits coverage is purchased under this
subchapter that differ from the rules and procedures generally
applicable to the child health plan program.
Sec. 62.253. CROWD-OUT. To the extent allowed by federal
law, the buy-in option developed under this subchapter must include
provisions designed to discourage:
(1) employers and other persons from electing to
discontinue offering health benefits plan coverage for employees'
children under employee or other group health benefits plans; and
(2) individuals with access to adequate health
benefits plan coverage for their children from electing not to
obtain, or to discontinue, that coverage.
SECTION 5. Sections 62.102(b) and (c), Health and Safety
Code, are repealed.
SECTION 6. Not later than January 1, 2010, the executive
commissioner of the Health and Human Services Commission shall
adopt rules as necessary to implement Subchapter F, Chapter 62,
Health and Safety Code, as added by this Act.
SECTION 7. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency 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 8. This Act takes effect September 1, 2009.