Texas 2021 - 87th Regular

Texas House Bill HB4084 Compare Versions

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

Old	New	Differences
1	1	87R10536 MM-D
2	2	By: Talarico H.B. No. 4084
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to establishing the Texas Care Plan Medicaid buy-in
8	8	program to provide health benefit plan coverage to certain persons
9	9	in this state.
10	10	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
11	11	SECTION 1. Subchapter B, Chapter 531, Government Code, is
12	12	amended by adding Section 531.024443 to read as follows:
13	13	Sec. 531.024443. TEXAS CARE PLAN MEDICAID BUY-IN PROGRAM.
14	14	(a) In this section, "program" means the Texas Care Plan Medicaid
15	15	buy-in program implemented under this section.
16	16	(b) The commission shall seek a waiver under Section 1115 of
17	17	the Social Security Act (42 U.S.C. Section 1315) to implement the
18	18	Texas Care Plan Medicaid buy-in program in accordance with this
19	19	section.
20	20	(c) The commission in consultation with the commissioner of
21	21	insurance shall develop the program to allow residents of this
22	22	state to purchase health benefit plan coverage through Medicaid by
23	23	enrolling in a managed care plan offered by a Medicaid managed care
24	24	organization.
25	25	(d) The executive commissioner shall adopt rules for the
26	26	program that:
27	27	(1) establish eligibility requirements for
28	28	participation, including:
29	29	(A) household income limits;
30	30	(B) a requirement that a program participant be
31	31	ineligible for benefits under Medicaid, other than through the
32	32	program; and
33	33	(C) a requirement that a program participant not
34	34	have health benefit coverage under another health benefit plan
35	35	because the participant does not have access to or cannot afford
36	36	coverage through an employer-sponsored health benefit plan; and
37	37	(2) require financial participation by a program
38	38	participant, including a requirement that a program participant
39	39	pay, according to a sliding scale based on household income
40	40	determined in accordance with commission rules that are consistent
41	41	with the cost-sharing reduction eligibility categories provided by
42	42	45 C.F.R. Section 155.305(g), a portion of premiums imposed or
43	43	cost-sharing payments required under the program.
44	44	(e) The program must be designed to leverage enhanced
45	45	federal medical assistance percentage funding available under the
46	46	Patient Protection and Affordable Care Act (Pub. L. No. 111-148) as
47	47	amended by the Health Care and Education Reconciliation Act of 2010
48	48	(Pub. L. No. 111-152).
49	49	(f) The program, including benefits offered under the
50	50	program, must be substantively identical to the Medicaid buy-in
51	51	programs established under Section 531.02444, except:
52	52	(1) to the extent that programmatic differences are
53	53	appropriate because of the populations served by the programs; and
54	54	(2) that a health benefit plan under the program is not
55	55	required to include nonemergency transportation services as
56	56	defined by Section 531.02414.
57	57	SECTION 2. As soon as practicable after the effective date
58	58	of this Act, the executive commissioner of the Health and Human
59	59	Services Commission shall apply for and actively pursue the waiver
60	60	from the Centers for Medicare and Medicaid Services or any other
61	61	federal agency required by Section 531.024443(b), Government Code,
62	62	as added by this Act. The commission may delay implementing Section
63	63	531.024443, Government Code, as added by this Act, until the waiver
64	64	applied for under this section is granted.
65	65	SECTION 3. This Act takes effect immediately if it receives
66	66	a vote of two-thirds of all the members elected to each house, as
67	67	provided by Section 39, Article III, Texas Constitution. If this
68	68	Act does not receive the vote necessary for immediate effect, this
69	69	Act takes effect September 1, 2021.