By: Bernal H.B. No. 131
A BILL TO BE ENTITLED
AN ACT
relating to the creation of a Medicaid buy-in program for certain
low-income individuals through the expansion of Medicaid under the
federal Patient Protection and Affordable Care Act.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
Section 1. Chapter 32, Human Resources Code, is amended by
adding Subchapter H to read as follows:
SUBCHAPTER H. EXPANSION OF ELIGIBILITY FOR MEDICAL ASSISTANCE
Sec. 32.351. EXPANDED ELIGIBILITY FOR MEDICAL ASSISTANCE
UNDER PATIENT PROTECTION AND AFFORDABLE CARE ACT. (a)
Notwithstanding any other law, the commission shall provide medical
assistance to all persons who apply for that assistance and for whom
federal matching funds are available under the Patient Protection
and Affordable Care Act (Pub. L. No. 111-148), as amended by the
Health Care and Education Reconciliation Act of 2010 (Pub. L. No.
111-152), to provide that assistance.
(b) The executive commissioner shall adopt rules regarding
the provision of medical assistance as required by this section.
Sec. 32.352. ANNUAL REPORT ON EXPANDED ELIGIBILITY FOR
MEDICAL ASSISTANCE. Not later than December 1 of each year, the
commission shall report to the governor, the lieutenant governor,
the speaker of the house of representatives, and the standing
committees of the senate and the house of representatives having
primary jurisdiction over the medical assistance program on the
effects of expanding eligibility for medical assistance under
Section 32.351, including the effects on:
(1) the number of persons in this state who do not have
health benefits coverage;
(2) state health care costs, including costs relating
to programs funded with money appropriated out of the general
revenue fund;
(3) local health care costs; and
(4) charity care and uncompensated care costs for
hospitals.
SECTION 2. Subtitle I, Title 4, Government Code, is amended
by adding Chapter 540 to read as follows:
CHAPTER 540. PROGRAM TO ENSURE HEALTH BENEFIT PLAN COVERAGE FOR
CERTAIN CHILDREN THROUGH A MEDICAID BUY-IN PROGRAM
Sec. 540.0001. PROGRAM FOR HEALTH BENEFIT PLAN COVERAGE FOR
CHILDREN THROUGH A MEDICAID BUY-IN PROGRAM. The commission in
consultation with the commissioner of insurance shall develop and
implement a program that allows certain individuals to purchase
health benefit plan coverage from a managed care organization
enrolled in the state Medicaid program.
Sec. 540.0002. ENROLLMENT ELIGIBILITY. (a) A child is
eligible to enroll in a program designed and established under this
chapter if the child:
(1) is younger than 19 years of age; and
(2) does not have health benefit coverage under a
health benefit plan because the child's family does not have access
to or cannot afford a plan through the private marketplace,
including:
(A) an employer-sponsored health benefit plan;
or
(B) a health benefit plan for which an enrollee
receives a premium subsidy under the Patient Protection and
Affordable Care Act (Pub. L. No. 111-148) due to the amount of
family income.
Sec. 540.0003. MINIMUM PROGRAM REQUIREMENTS. A program
designed and established under this chapter must:
(1) provide children whose family's income is at or
below 200% of the federal poverty level the ability to buy into the
state Medicaid program; and
(2) create a sliding-scale premium for families whose
income is between 133% and 200% of the federal poverty level.
Sec. 540.0004. RULES. The executive commissioner may adopt
rules necessary to implement this chapter.
SECTION 3. Section 32.351, Human Resources Code, as added
by this Act, applies only to an initial determination or
recertification of eligibility of a person for medical assistance
under Chapter 32, Human Resources Code, made on or after the date
the section is implemented, regardless of the date the person
applied for that assistance.
SECTION 4. As soon as possible after the effective date of
this Act, the executive commissioner of the Health and Human
Services Commission shall take all necessary actions to expand
eligibility for medical assistance under Chapter 32, Human
Resources Code, in accordance with Section 32.351, Human Resources
Code, as added by this Act, including notifying appropriate federal
agencies of that expanded eligibility. If before implementing any
provision of this Act a state agency determines that any other
waiver or authorization from a federal agency is necessary for
implementation of that provision, the agency affected by the
provision shall request the waiver or authorization and may delay
implementing that provision until the waiver or authorization is
granted.
SECTION 5. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall develop and implement the program
required by Chapter 540, Government Code, as added by this Act.
SECTION 6. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 7. This Act takes effect September 1, 2021.