By: Phillips H.B. No. 3226
A BILL TO BE ENTITLED
AN ACT
Relating to the creation of the Temporary Texas Health Insurance
Risk Pool
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle G, Insurance Code, is amended by adding
Chapter 1510 to read as follows:
CHAPTER 1510. TEXAS TEMPORARY HEALTH INSURANCE POOL
Sec. 1510.101 ESTABLISHMENT OF TEMPORARY HEALTH INSURANCE
RISK POOL. To the extent that federal funds become available under
federal law, regulation, or executive action after March 1, 2017,
the commissioner may apply for such funds and use such funds to
establish and administer a temporary health insurance risk pool
from which funds may be used for the purposes of this chapter.
Sec. 1510.102. PURPOSES OF TEMPORARY POOL. (a) The purpose
of the pool is to provide a temporary mechanism for maximizing
available federal funding to assist Texas residents in obtaining
access to quality health care at minimum cost to the public.
(b) The pool may not be used to expand the Medicaid program
under Chapter 32 of the Human Resources Code.
Sec. 1510.103. PROVIDING COVERAGE. (a) Subject to any
requirements for obtaining federal funds held within the pool, the
commissioner may use pool funds to provide alternative individual
health insurance coverage to eligible individuals without
diminishing the availability of traditional commercial health care
coverage, provide funding to individual health benefit plan
insurers covering individuals with certain health or cost
characteristics in exchange for lower individual health plan
premium rates, or provide a reinsurance program for carriers in the
individual market in exchange for lower individual health plan
premium rates.
Sec. 1510.104. CONTRACTS. (a) The commissioner may enter
into any contract or agreement that the commissioner considers
appropriate to carry out this chapter, including a contract or
agreement with:
(1) a similar pool in another state for the joint
performance of common administrative functions;
(2) another organization for the performance of
administrative functions; or
(3) with a federal agency.
(b) The commissioner may contract for stop-loss insurance
for risks incurred under this Chapter.
Sec. 1510.105. FUNDING. (a) The commissioner may use funds
appropriated to the department to apply for federal funding and
grants and to administer this Chapter.
(b) The commissioner may use federal funds to administer
this Chapter, as appropriate.
(c) Except as provided in this section, the commissioner may
not use any state funds to fund the Pool unless they are
specifically appropriated for that purpose.
(d) Notwithstanding Section 6(d)(2,) Chapter 615 (S.B.
1367), Acts of the 83rd Legislature, Regular Session, 2013, on or
after the effective date of this bill, the commissioner of
insurance shall transfer any funds remaining in the Texas Treasury
Safekeeping Trust Company account created under the provisions of
Section 6(c) of Chapter 615 (S.B. 1367), Acts of the 83rd
Legislature, Regular Session, 2013, to the fund established under
Subchapter F, Chapter 1508, Insurance Code.
(e) Notwithstanding Section 6(e)(2)(B), Chapter 615 (S.B.
1367), Acts of the 83rd Legislature, Regular Session, 2013, the
commissioner of insurance may use funds appropriated to the
department from the fund established under Subchapter F, Chapter
1508, Insurance Code, for the purposes of this chapter but
excluding salaries and salary related benefits.
(f) Notwithstanding Section 6(e)(2)(B), Chapter 615 (S.B.
1367), Acts of the 83rd Legislature, Regular Session, 2013, on or
after the effective date of this bill, the commissioner of
insurance shall transfer funds from the fund established under
Subchapter F, Chapter 1508, Insurance Code, to the General
Revenue-Dedicated Texas Department of Insurance Operating Fund 36
to cover the appropriations for direct and indirect costs for the
purposes of this chapter.
Sec. 1510.106. PUBLIC EDUCATION AND OUTREACH. (a) The
commissioner may use any funds appropriated to the department for
the purposes of this chapter to develop and implement public
education, outreach, and facilitated enrollment strategies under
this chapter.
(b) The commissioner may contract with marketing
organizations to perform or provide assistance with education,
outreach, and enrollment strategies described by Subsection (a).
Sec. 1510.107. WAIVER. The commissioner is authorized, and
may take any action the commissioner considers appropriate, to
apply to the United States Secretary of Health and Human Services
under 42 U.S.C. ยง18052 for a waiver of applicable provisions of P.L.
111-148 (Patient Protection and Affordable Care Act) and any
applicable regulations or guidance with respect to health insurance
coverage in the state for a plan year beginning on or after January
1, 2017. The commissioner may implement a state plan meeting the
waiver requirements in a manner consistent with state and federal
law and as approved by the United States Secretary of Health and
Human Services.
Sec. 1510.108. ADDITIONAL AUTHORITY. In addition to the
other powers granted under this chapter, the commissioner may
exercise any authority that a reinsurer, or a health benefit plan
issuer authorized to write health benefit plans in this state, may
exercise under the law of this state.
Sec. 1510.198. RULES. The commissioner may adopt rules
necessary and appropriate to implement this chapter, including the
administration of the pool and distribution of money from the pool.
Sec. 1510.110. EXEMPTION FROM STATE TAXES AND FEES. The
programs created under this Chapter are not subject to any state
tax, regulatory fee, or surcharge, including a premium or
maintenance tax or fee.
Sec. 1510.111. ANNUAL REPORT OF POOL'S ACTIVITIES. (a)
Beginning in June of 2018, not later than June 1 of each year, the
Department shall submit a report to the governor, the lieutenant
governor, and the speaker of the house of representatives.
(b) The report must summarize the activities conducted
under this chapter in the calendar year preceding the year in which
the report is submitted and must include information relating to
net written and earned premiums, plan enrollment, administration
expenses, and paid and incurred losses.
SECTION 2. 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 votes necessary for immediate effect, this
Act takes effect September 1, 2017. This Chapter expires August 31,
2019, unless extended by the Legislature.