LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 84TH LEGISLATIVE REGULAR SESSION May 20, 2015 TO: Honorable Charles Schwertner, Chair, Senate Committee on Health & Human Services FROM: Ursula Parks, Director, Legislative Budget Board IN RE:HB839 by Naishtat (Relating to eligibility for Medicaid and the child health plan program for certain children.), As Engrossed Estimated Two-year Net Impact to General Revenue Related Funds for HB839, As Engrossed: a negative impact of ($682,074) through the biennium ending August 31, 2017. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 84TH LEGISLATIVE REGULAR SESSION May 20, 2015 TO: Honorable Charles Schwertner, Chair, Senate Committee on Health & Human Services FROM: Ursula Parks, Director, Legislative Budget Board IN RE:HB839 by Naishtat (Relating to eligibility for Medicaid and the child health plan program for certain children.), As Engrossed TO: Honorable Charles Schwertner, Chair, Senate Committee on Health & Human Services FROM: Ursula Parks, Director, Legislative Budget Board IN RE: HB839 by Naishtat (Relating to eligibility for Medicaid and the child health plan program for certain children.), As Engrossed Honorable Charles Schwertner, Chair, Senate Committee on Health & Human Services Honorable Charles Schwertner, Chair, Senate Committee on Health & Human Services Ursula Parks, Director, Legislative Budget Board Ursula Parks, Director, Legislative Budget Board HB839 by Naishtat (Relating to eligibility for Medicaid and the child health plan program for certain children.), As Engrossed HB839 by Naishtat (Relating to eligibility for Medicaid and the child health plan program for certain children.), As Engrossed Estimated Two-year Net Impact to General Revenue Related Funds for HB839, As Engrossed: a negative impact of ($682,074) through the biennium ending August 31, 2017. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. Estimated Two-year Net Impact to General Revenue Related Funds for HB839, As Engrossed: a negative impact of ($682,074) through the biennium ending August 31, 2017. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. General Revenue-Related Funds, Five-Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact to General Revenue Related Funds 2016 ($257,500) 2017 ($424,574) 2018 ($765,278) 2019 ($773,842) 2020 ($818,661) 2016 ($257,500) 2017 ($424,574) 2018 ($765,278) 2019 ($773,842) 2020 ($818,661) All Funds, Five-Year Impact: Fiscal Year Probable Savings/(Cost) fromGeneral Revenue Fund1 Probable Savings/(Cost) fromGR Match For Title XXI8010 Probable Savings/(Cost) fromFederal Funds555 2016 ($257,500) $0 ($772,500) 2017 ($418,021) ($6,553) ($639,861) 2018 ($753,573) ($11,705) ($1,151,437) 2019 ($761,959) ($11,883) ($1,164,866) 2020 ($771,543) ($47,118) ($1,142,331) Fiscal Year Probable Savings/(Cost) fromGeneral Revenue Fund1 Probable Savings/(Cost) fromGR Match For Title XXI8010 Probable Savings/(Cost) fromFederal Funds555 2016 ($257,500) $0 ($772,500) 2017 ($418,021) ($6,553) ($639,861) 2018 ($753,573) ($11,705) ($1,151,437) 2019 ($761,959) ($11,883) ($1,164,866) 2020 ($771,543) ($47,118) ($1,142,331) 2016 ($257,500) $0 ($772,500) 2017 ($418,021) ($6,553) ($639,861) 2018 ($753,573) ($11,705) ($1,151,437) 2019 ($761,959) ($11,883) ($1,164,866) 2020 ($771,543) ($47,118) ($1,142,331) Fiscal Analysis The bill would require the executive commissioner of the Health and Human Services Commission (HHSC) to adopt rules providing for presumptive eligibility for Medicaid and the Children's Health Insurance Program (CHIP) for children released from certain juvenile justice settings. Further, HHSC would be required to reinstate the health benefits coverage of a child released from a juvenile facility within 48 hours after notification of the child's release. The juvenile facility would be required to notify HHSC within 30 days after the child's release from confinement. The agency would be directed to seek any necessary federal waiver or authorization and could delay implementation of any provision until such waiver or authorization is granted. The executive commissioner of HHSC would be required to adopt rules related to the bill by January 1, 2016. Methodology This analysis estimates that there would be one-time costs for modifications to the Texas Integrated Eligibility and Redesign System (TIERS) of $1.0 million in fiscal year 2016. It is assumed there would be additional costs to provide Medicaid or CHIP benefits to eligible children beginning in fiscal year 2017. It is assumed that the number of children who would be found presumptively eligible and later determined ineligible for the programs would be small. There would also be an increase to the number of children enrolled in the programs who were previously eligible but unenrolled. There would also be a number of children whose eligibility is reinstated that would otherwise be discontinued. The cost to provide services to these children is estimated to be $1.1 million in fiscal year 2017, $1.9 million in fiscal year 2018 and increase slightly to $2.0 million in fiscal year 2020. There would be a minimal increase to premium tax revenue beginning in fiscal year 2017. Technology There would be one-time costs for system modification to TIERS totaling $1.0 million in fiscal year 2016. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies: LBB Staff: UP, NB, WP UP, NB, WP