Texas 2017 - 85th Regular

Texas House Bill HB4068 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	85R14756 SCL-F
2	2	By: Gooden H.B. No. 4068
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to regional or local health care programs for eligible
8	8	individuals and employees of small employers.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. The heading to Chapter 75, Health and Safety
11	11	Code, is amended to read as follows:
12	12	CHAPTER 75. REGIONAL OR LOCAL HEALTH CARE PROGRAMS FOR ELIGIBLE
13	13	INDIVIDUALS AND EMPLOYEES OF SMALL EMPLOYERS
14	14	SECTION 2. Section 75.001, Health and Safety Code, is
15	15	amended to read as follows:
16	16	Sec. 75.001. PURPOSE. The purpose of this chapter is to:
17	17	(1) improve the health of eligible individuals and
18	18	employees of small employers and their families by improving the
19	19	individuals' and employees' access to health care and by reducing
20	20	the number of those individuals and employees who are uninsured;
21	21	(2) reduce the likelihood that those individuals and
22	22	employees and their families will require services from
23	23	state-funded entitlement programs such as Medicaid;
24	24	(3) contribute to economic development by helping
25	25	small businesses remain competitive with a healthy workforce and
26	26	optional health care benefits that will attract employees; and
27	27	(4) encourage innovative solutions for providing and
28	28	funding health care services and benefits.
29	29	SECTION 3. Section 75.002, Health and Safety Code, is
30	30	amended by amending Subdivisions (1), (3), and (4) and adding
31	31	Subdivision (1-a) to read as follows:
32	32	(1) "Eligible individual" means an individual
33	33	eligible for participation in a regional or local health care
34	34	program established under this chapter.
35	35	(1-a) "Employee" means an individual employed by an
36	36	employer. The term includes a partner of a partnership and the
37	37	proprietor of a sole proprietorship.
38	38	(3) "Local health care program" means a local health
39	39	care program operating in one county and established for the
40	40	benefit of eligible individuals and the employees of small
41	41	employers under Subchapter B.
42	42	(4) "Regional health care program" means a regional
43	43	health care program operating in two or more counties and
44	44	established for the benefit of eligible individuals and the
45	45	employees of small employers under Subchapter B.
46	46	SECTION 4. Sections 75.052 and 75.053, Health and Safety
47	47	Code, are amended to read as follows:
48	48	Sec. 75.052. GOVERNANCE OF PROGRAM. (a) [A regional health
49	49	care program may be operated subject to the direct governance of the
50	50	commissioners courts of the participating counties. A local health
51	51	care program may be operated subject to the direct governance of the
52	52	commissioners court of the participating county.] A regional or
53	53	local health care program must [may] be operated by a [joint
54	54	council,] tax-exempt nonprofit entity[, or other entity that:
55	55	[(1) operates the program under a contract with the
56	56	commissioners court or courts, as applicable; or
57	57	[(2) is an entity in which the county or counties
58	58	participate or that is established or designated by the
59	59	commissioners court or courts, as applicable, to operate the
60	60	program].
61	61	(b) An [In selecting an] entity operating [described by
62	62	Subsection (a)(1) or (2) to operate] a regional or local health care
63	63	program must [, the commissioners court or courts, as applicable,
64	64	shall require, to the extent possible, that the entity] be
65	65	authorized under federal law to accept donations on a basis that is
66	66	tax-deductible or otherwise tax-advantaged for the contributor.
67	67	Sec. 75.053. OPERATION OF PROGRAM. A regional or local
68	68	health care program provides health care services or benefits to
69	69	eligible individuals and the employees of participating small
70	70	employers who are located within the boundaries of the
71	71	participating county or counties, as applicable. A program may
72	72	also provide services or benefits to the dependents of those
73	73	individuals and employees.
74	74	SECTION 5. Subchapter B, Chapter 75, Health and Safety
75	75	Code, is amended by adding Section 75.0545 to read as follows:
76	76	Sec. 75.0545. PARTICIPATION BY ELIGIBLE INDIVIDUALS; SHARE
77	77	OF COST. Subject to Section 75.153, the governing body may
78	78	establish criteria for participation in a regional or local health
79	79	care program by eligible individuals and their dependents. The
80	80	criteria must require that participating individuals pay a share of
81	81	the premium or other cost of the program.
82	82	SECTION 6. Section 75.055(c), Health and Safety Code, is
83	83	amended to read as follows:
84	84	(c) A governing body shall actively solicit gifts, grants,
85	85	and donations to:
86	86	(1) fund services and benefits provided under the
87	87	regional or local health care program; and
88	88	(2) reduce the cost of participation in the program
89	89	for eligible individuals and for small employers and their
90	90	employees.
91	91	SECTION 7. Section 75.101, Health and Safety Code, is
92	92	amended to read as follows:
93	93	Sec. 75.101. ALTERNATIVE PROGRAMS AUTHORIZED; PROGRAM
94	94	OBJECTIVES. In developing a regional or local health care program,
95	95	a governing body may provide health care services or benefits as
96	96	described by this subchapter or may develop another type of program
97	97	to accomplish the purposes of this chapter. A regional or local
98	98	health care program must be developed, to the extent practicable,
99	99	to:
100	100	(1) reduce the number of individuals without health
101	101	benefit plan coverage [within the boundaries of the participating
102	102	county or counties];
103	103	(2) address rising health care costs and reduce the
104	104	cost of health care services or health benefit plan coverage [for
105	105	small employers and their employees within the boundaries of the
106	106	participating county or counties];
107	107	(3) promote preventive care and reduce the incidence
108	108	of preventable health conditions, such as heart disease, cancer,
109	109	and diabetes and low birth weight in infants;
110	110	(4) promote efficient and collaborative delivery of
111	111	health care services;
112	112	(5) serve as a model for the innovative use of health
113	113	information technology to promote efficient delivery of health care
114	114	services, reduce health care costs, and improve the health of the
115	115	community; and
116	116	(6) provide fair payment rates for health care
117	117	providers, to the extent applicable.
118	118	SECTION 8. Sections 75.102(a), (c), and (d), Health and
119	119	Safety Code, are amended to read as follows:
120	120	(a) A regional or local health care program may provide
121	121	health care benefits to eligible individuals and the employees of
122	122	small employers by purchasing or facilitating the purchase of
123	123	health benefit plan coverage for those individuals and employees
124	124	from a health benefit plan issuer, including coverage under:
125	125	(1) a small employer health benefit plan offered under
126	126	Chapter 1501, Insurance Code;
127	127	(2) a standard health benefit plan offered under
128	128	Chapter 1507, Insurance Code; or
129	129	(3) any other health benefit plan available in this
130	130	state.
131	131	(c) Notwithstanding Chapter 1251, Insurance Code, an
132	132	insurer may issue a group accident and health insurance policy,
133	133	including a group contract issued by a group hospital service
134	134	corporation, to cover eligible individuals and the employees of
135	135	small employers participating in a regional or local health care
136	136	program. The group policyholder of a policy issued in accordance
137	137	with this subsection is the governing body or the designee of the
138	138	governing body.
139	139	(d) A health maintenance organization may issue a health
140	140	care plan to cover eligible individuals and the employees of small
141	141	employers participating in a regional or local health care program.
142	142	The group contract holder of a contract issued in accordance with
143	143	this subsection is the governing body or the designee of the
144	144	governing body.
145	145	SECTION 9. Sections 75.104(a) and (c), Health and Safety
146	146	Code, are amended to read as follows:
147	147	(a) A regional or local health care program may contract
148	148	with health care providers within the boundaries of the
149	149	participating county or counties to provide health care services
150	150	directly to eligible individuals, the employees of participating
151	151	small employers, and the dependents of those individuals and
152	152	employees.
153	153	(c) A governing body that operates a regional or local
154	154	health care program under this section may require that
155	155	participating eligible individuals, employees, and dependents
156	156	obtain health care services only from health care providers that
157	157	contract to provide those services under the program and may limit
158	158	the health care services provided under the program to services
159	159	provided within the boundaries of the program's service area
160	160	[participating county or counties].
161	161	SECTION 10. This Act takes effect September 1, 2017.