85R20635 BEE-F
By: Phillips H.B. No. 3226
Substitute the following for H.B. No. 3226:
By: Phillips C.S.H.B. No. 3226
A BILL TO BE ENTITLED
AN ACT
relating to the creation of a temporary health insurance risk pool.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle G, Title 8, Insurance Code, is amended
by adding Chapter 1510 to read as follows:
CHAPTER 1510. TEMPORARY HEALTH INSURANCE RISK POOL
Sec. 1510.001. DEFINITION. In this chapter, "pool" means a
temporary health insurance risk pool that is established and
administered by the commissioner under this chapter.
Sec. 1510.002. 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:
(1) apply for such funds; and
(2) use such funds to establish and administer a
temporary health insurance risk pool for the purposes of this
chapter.
Sec. 1510.003. PURPOSE OF POOL. (a) The exclusive purpose
of the pool is to provide a temporary mechanism for maximizing
available federal funding to assist residents of this state 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,
including the program administered under Chapter 32, Human
Resources Code, and the program administered under Chapter 533,
Government Code.
Sec. 1510.004. PROVISION OF COVERAGE. Subject to any
requirements for obtaining federal funds held in the pool, the
commissioner may use pool funds:
(1) to provide alternative individual health
insurance coverage to eligible individuals that does not diminish
the availability of traditional commercial health care coverage;
(2) to provide funding to individual health benefit
plan issuers that cover individuals with certain health or cost
characteristics in exchange for lower enrollee premium rates; or
(3) to provide a reinsurance program for health
benefit plan issuers in the individual market in exchange for lower
enrollee premium rates.
Sec. 1510.005. CONTRACTS AND AGREEMENTS. (a) The
commissioner may enter into a contract or agreement that the
commissioner determines is 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) a federal agency.
(b) The commissioner may contract for stop-loss insurance
for risks incurred under this chapter.
Sec. 1510.006. FUNDING. (a) The commissioner may use funds
appropriated to the department to:
(1) apply for federal funding and grants; and
(2) administer this chapter.
(b) Notwithstanding Section 6(e)(2)(B), Chapter 615 (S.B.
1367), Acts of the 83rd Legislature, Regular Session, 2013, the
commissioner may use money appropriated to the department from the
healthy Texas small employer premium stabilization fund for the
exclusive purposes of this chapter, other than for paying salaries
and salary-related benefits.
(c) Notwithstanding Section 6(e)(2)(B), Chapter 615 (S.B.
1367), Acts of the 83rd Legislature, Regular Session, 2013, the
commissioner shall transfer money from the healthy Texas small
employer premium stabilization fund to the Texas Department of
Insurance operating account in an amount equal to the amount of
money appropriated to the department from that fund, as described
by Subsection (b), for the direct and indirect costs of the
exclusive purposes of this chapter.
(d) Except as provided by Subsections (a) and (b), the
commissioner may not use any state funds to fund the pool unless the
funds are specifically appropriated for that purpose.
(e) The commissioner may use federal funds to administer
this chapter, as appropriate.
Sec. 1510.007. PUBLIC EDUCATION AND OUTREACH. (a) The
commissioner may use funds appropriated to the department for the
exclusive 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 the strategies
described by Subsection (a).
Sec. 1510.008. WAIVER. (a) The commissioner may apply to
the United States secretary of health and human services under 42
U.S.C. Section 18052 for a waiver of applicable provisions of the
Patient Protection and Affordable Care Act (Pub. L. No. 111-148)
and any applicable regulations or guidance with respect to health
insurance coverage in this state for a plan year beginning on or
after January 1, 2017.
(b) The commissioner may take any action the commissioner
considers appropriate to make an application under this section.
(c) The commissioner may implement a state plan that meets
the requirements of a waiver granted in response to an application
under Subsection (a) if the plan is:
(1) consistent with state and federal law; and
(2) approved by the United States secretary of health
and human services.
Sec. 1510.009. ADDITIONAL AUTHORITY. In addition to the
powers granted to the commissioner under this chapter, the
commissioner may exercise any authority that may be exercised under
the law of this state by:
(1) a reinsurer; or
(2) a health benefit plan issuer authorized to write
health benefit plans in this state.
Sec. 1510.010. RULES. The commissioner may adopt rules
necessary to implement this chapter, including rules to administer
the pool and distribute money from the pool.
Sec. 1510.011. EXEMPTION FROM STATE TAXES AND FEES.
Notwithstanding any other law, a program created under this chapter
is not subject to any state tax, regulatory fee, or surcharge,
including a premium or maintenance tax or fee.
Sec. 1510.012. ANNUAL REPORT OF POOL ACTIVITIES. (a)
Beginning June 1, 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 submitted under Subsection (a) must:
(1) summarize the activities conducted under this
chapter in the calendar year preceding the year in which the report
is submitted; and
(2) include information relating to:
(A) net written and earned premiums;
(B) plan enrollment;
(C) administration expenses; and
(D) paid and incurred losses.
Sec. 1510.013. EXPIRATION OF CHAPTER. This chapter expires
August 31, 2019.
SECTION 2. Notwithstanding Section 6(d)(2), Chapter 615
(S.B. 1367), Acts of the 83rd Legislature, Regular Session, 2013,
on the effective date of this Act, the commissioner of insurance
shall transfer any money remaining outside the state treasury in
the Texas Treasury Safekeeping Trust Company account established
under Section 6(c), Chapter 615 (S.B. 1367), Acts of the 83rd
Legislature, Regular Session, 2013, to the healthy Texas small
employer premium stabilization fund.
SECTION 3. 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, 2017.