By: Nelson S.B. No. 1057
A BILL TO BE ENTITLED
AN ACT
relating to information about private health care insurance
coverage and the health insurance exchange for individuals applying
for certain Department of State Health Services programs and
services.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subchapter D, Chapter 1001, Health and Safety
Code, is amended by adding Sections 1001.080 and 1001.081 to read as
follows:
Sec. 1001.080. HEALTH INSURANCE COVERAGE INFORMATION. (a)
In this section, "individual's legally authorized representative"
means:
(1) a parent, managing conservator, or guardian of an
individual, if the individual is a minor;
(2) a guardian of an individual, if the individual has
been adjudicated incompetent to manage the individual's personal
affairs; or
(3) an agent of the individual authorized under a
durable power of attorney for health care.
(b) This section applies to a health or mental health
program or service provided by the department or under a department
program that the department anticipates will be impacted by a
health insurance exchange as defined by Section 1001.081(a),
including:
(1) community primary health care services provided
under Chapter 31;
(2) women's and children's health services provided
under Chapter 32;
(3) services for children with special health care
needs provided under Chapter 35;
(4) epilepsy program assistance provided under
Chapter 40;
(5) hemophilia program assistance provided under
Chapter 41;
(6) kidney health care services provided under Chapter
42;
(7) human immunodeficiency virus infection and
sexually transmitted disease prevention programs and services
provided under Chapter 85;
(8) immunization programs provided under Chapter 161;
(9) programs and services provided by the Rio Grande
State Center under Chapter 252;
(10) mental health services for adults provided under
Chapter 534;
(11) mental health services for children provided
under Chapter 534;
(12) the NorthSTAR Behavioral Health Program provided
under Chapter 534;
(13) programs and services provided by community
mental health hospitals under Chapter 552;
(14) programs and services provided by state mental
health hospitals under Chapter 552; and
(15) any other health or mental health program or
service designated by the department.
(c) Subject to Subsection (d), the department may not
provide a health or mental health program or service described in
Subsection (b), unless the individual applying to receive the
program or service submits to the department on the form prescribed
by the department a statement by the individual or the individual's
legally authorized representative attesting that the individual
does not have access to private health care insurance coverage that
provides benefits for the services provided under the program or
service.
(d) The department may waive the prohibition under
Subsection (c) for an individual or for a mental health program or
service described in Subsection (b) if the department determines
that the program or service is necessary during a crisis or
emergency.
(e) The executive commissioner shall adopt rules necessary
to implement this section.
Sec. 1001.081. HEALTH INSURANCE EXCHANGE INFORMATION. (a)
In this section:
(1) "Health insurance exchange" means an American
Health Benefit Exchange administered by the federal government
under 42 U.S.C. Section 18041 or created under 42 U.S.C. Section
18031.
(2) "Individual's legally authorized representative"
has the meaning assigned by Section 1001.080(a).
(b) The department shall develop informational materials
regarding health care insurance coverage and subsidies available
under a health insurance exchange. The informational materials
must be in English and in Spanish, and to the extent possible, in
other languages.
(c) The department shall distribute the informational
materials developed under Subsection (b) to an individual or the
individual's legally authorized representative who:
(1) applies to receive a health or mental health
program or service described in Section 1001.080(b); and
(2) has an income above 100 percent of the federal
poverty level.
(d) The executive commissioner shall adopt rules necessary
to implement this section.
SECTION 2. As soon as practicable after the effective date
of this Act, the Department of State Health Services shall
prescribe the form required by Section 1001.080, Health and Safety
Code, as added by this Act.
SECTION 3. Not later than June 1, 2014, the Department of
State Health Services shall make available the informational
materials required by Section 1001.081, Health and Safety Code, as
added by this Act.
SECTION 4. As soon as possible after the effective date of
this Act, the Health and Human Services Commission shall apply for
any waiver or other authorization necessary to implement this Act.
The commission may delay implementing this Act until the waiver or
authorization is granted.
SECTION 5. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2013.