LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION March 18, 2025 TO: Honorable Jay Dean, Chair, House Committee on Insurance FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB138 by Dean (Relating to the establishment of the Health Impact, Cost, and Coverage Analysis Program; authorizing a fee.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB138, As Introduced: an impact of $0 through the biennium ending August 31, 2027. This bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement provisions of the bill. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2026$02027$02028$02029$02030$0All Funds, Five-Year Impact: Fiscal Year Probable (Cost) fromGeneral Revenue Fund1 Probable Revenue Gain fromGeneral Revenue Fund1 Change in Number of State Employees from FY 20252026($1,969,000)$1,969,0006.02027($1,969,000)$1,969,0006.02028($2,057,000)$2,057,0006.02029($2,057,000)$2,057,0006.02030($2,182,000)$2,182,0006.0 Fiscal AnalysisThe bill requires the Center for Health Care Data (the Center) at The University of Texas Health Science Center at Houston (UTHSC Houston) to establish the Health Impact, Cost, and Coverage Analysis Program (the Program) to prepare analyses of proposed legislation that would impose new mandates on health benefit plan issuers or administrators.The bill requires the Comptroller of Public Accounts to assess an annual fee on each health benefit plan issuer that is not operating solely as a Medicaid managed care organization in an amount necessary to cover the cost of implementing and operating the Program. The bill requires the Comptroller, in consultation with the Center, to determine the necessary amount of the fee and adjust the amount as needed to cover increases in costs, or deficits incurred during the preceding fiscal year, in each fiscal biennium. The legislature may appropriate money received from the issuance of the fee only to the Center.Note: This legislation would do one or more of the following: create or recreate a dedicated account in the General Revenue Fund, create or recreate a special or trust fund either in, with, or outside the Treasury, or create a dedicated revenue source. The fund, account, or revenue dedication included in this bill would be subject to funds consolidation review by the current Legislature.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION
March 18, 2025
TO: Honorable Jay Dean, Chair, House Committee on Insurance FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB138 by Dean (Relating to the establishment of the Health Impact, Cost, and Coverage Analysis Program; authorizing a fee.), As Introduced
TO: Honorable Jay Dean, Chair, House Committee on Insurance
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: HB138 by Dean (Relating to the establishment of the Health Impact, Cost, and Coverage Analysis Program; authorizing a fee.), As Introduced
Honorable Jay Dean, Chair, House Committee on Insurance
Honorable Jay Dean, Chair, House Committee on Insurance
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
HB138 by Dean (Relating to the establishment of the Health Impact, Cost, and Coverage Analysis Program; authorizing a fee.), As Introduced
HB138 by Dean (Relating to the establishment of the Health Impact, Cost, and Coverage Analysis Program; authorizing a fee.), As Introduced
Estimated Two-year Net Impact to General Revenue Related Funds for HB138, As Introduced: an impact of $0 through the biennium ending August 31, 2027. This bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement provisions of the bill.
Estimated Two-year Net Impact to General Revenue Related Funds for HB138, As Introduced: an impact of $0 through the biennium ending August 31, 2027. This bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement provisions of the bill.
This bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement provisions of the bill.
General Revenue-Related Funds, Five- Year Impact:
2026 $0
2027 $0
2028 $0
2029 $0
2030 $0
All Funds, Five-Year Impact:
2026 ($1,969,000) $1,969,000 6.0
2027 ($1,969,000) $1,969,000 6.0
2028 ($2,057,000) $2,057,000 6.0
2029 ($2,057,000) $2,057,000 6.0
2030 ($2,182,000) $2,182,000 6.0
Fiscal Analysis
The bill requires the Center for Health Care Data (the Center) at The University of Texas Health Science Center at Houston (UTHSC Houston) to establish the Health Impact, Cost, and Coverage Analysis Program (the Program) to prepare analyses of proposed legislation that would impose new mandates on health benefit plan issuers or administrators.The bill requires the Comptroller of Public Accounts to assess an annual fee on each health benefit plan issuer that is not operating solely as a Medicaid managed care organization in an amount necessary to cover the cost of implementing and operating the Program. The bill requires the Comptroller, in consultation with the Center, to determine the necessary amount of the fee and adjust the amount as needed to cover increases in costs, or deficits incurred during the preceding fiscal year, in each fiscal biennium. The legislature may appropriate money received from the issuance of the fee only to the Center.Note: This legislation would do one or more of the following: create or recreate a dedicated account in the General Revenue Fund, create or recreate a special or trust fund either in, with, or outside the Treasury, or create a dedicated revenue source. The fund, account, or revenue dedication included in this bill would be subject to funds consolidation review by the current Legislature.
Methodology
According to UTHSC Houston, 5.0 FTEs would be needed to implement the provisions of the bill, along with certain professional services and required external review services. This analysis assumes a fee will be assessed by the Comptroller in the amount necessary to implement the Program to cover the General Revenue impact, thus leading to no significant statewide fiscal impact.The fiscal impact assumes that the annual fee in a biennium will be set at the estimated average annual cost of the Program. The Comptroller anticipates administrative costs associated with hiring 1.0 FTE for implementation and future administration of the assessment and the collection of premium information to calculate the assessment amount for each issuer. It is assumed these administrative costs could be absorbed with existing funds. According to the Comptroller of Public Accounts, if the bill takes effect immediately upon enactment, there would be no significant cost of implementation in fiscal year 2025 and no fee assessment for that fiscal year.The Employee Retirement System of Texas and the Health and Human Services Commission have indicated there will be a fiscal impact to those agencies but that the amount cannot be determined since the amount of the fee that will be assessed to each agency is unknown.
The fiscal impact assumes that the annual fee in a biennium will be set at the estimated average annual cost of the Program. The Comptroller anticipates administrative costs associated with hiring 1.0 FTE for implementation and future administration of the assessment and the collection of premium information to calculate the assessment amount for each issuer. It is assumed these administrative costs could be absorbed with existing funds. According to the Comptroller of Public Accounts, if the bill takes effect immediately upon enactment, there would be no significant cost of implementation in fiscal year 2025 and no fee assessment for that fiscal year.The Employee Retirement System of Texas and the Health and Human Services Commission have indicated there will be a fiscal impact to those agencies but that the amount cannot be determined since the amount of the fee that will be assessed to each agency is unknown.
The Employee Retirement System of Texas and the Health and Human Services Commission have indicated there will be a fiscal impact to those agencies but that the amount cannot be determined since the amount of the fee that will be assessed to each agency is unknown.
The Employee Retirement System of Texas and the Health and Human Services Commission have indicated there will be a fiscal impact to those agencies but that the amount cannot be determined since the amount of the fee that will be assessed to each agency is unknown.
Technology
No technology impact is anticipated.
Local Government Impact
No fiscal implication to units of local government is anticipated.
Source Agencies: b > td > 304 Comptroller of Public Accounts, 323 Teacher Retirement System, 327 Employees Retirement System, 454 Department of Insurance, 529 Health and Human Services Commission, 710 Texas A&M University System Administrative and General Offices, 720 The University of Texas System Administration
304 Comptroller of Public Accounts, 323 Teacher Retirement System, 327 Employees Retirement System, 454 Department of Insurance, 529 Health and Human Services Commission, 710 Texas A&M University System Administrative and General Offices, 720 The University of Texas System Administration
LBB Staff: b > td > JMc, AAL, LBO, BCa
JMc, AAL, LBO, BCa