LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION March 26, 2025 TO: Honorable Gary VanDeaver, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1782 by Howard (Relating to eligibility for Medicaid for breast and cervical cancer.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB1782, As Introduced: a negative impact of ($1,674,063) through the biennium ending August 31, 2027. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2026$02027($1,674,063)2028($10,176,523)2029($21,096,550)2030($29,453,571)All Funds, Five-Year Impact: Fiscal Year Probable Savings/(Cost) fromGR Match For Medicaid758 Probable Savings/(Cost) fromFederal Funds555 Probable Revenue Gain/(Loss) fromGeneral Revenue Fund1 Probable Revenue Gain/(Loss) fromFoundation School Fund1932026$0$0$0$02027($1,914,486)($2,851,473)$180,317$60,1062028($10,812,769)($16,104,754)$477,185$159,0612029($22,188,161)($33,047,491)$818,708$272,9032030($30,795,157)($45,866,921)$1,006,190$335,396 Fiscal AnalysisThe bill would require the Health and Human Services Commission (HHSC) to increase the income limit from 200 percent of the Federal Poverty Level (FPL) to 250 percent of the FPL for breast and cervical cancer services in the Medicaid program.The bill would take effect immediately if it receives a vote of two-thirds of all the members elected to each house. Otherwise, the bill would take effect September 1, 2025. LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION March 26, 2025 TO: Honorable Gary VanDeaver, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1782 by Howard (Relating to eligibility for Medicaid for breast and cervical cancer.), As Introduced TO: Honorable Gary VanDeaver, Chair, House Committee on Public Health FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB1782 by Howard (Relating to eligibility for Medicaid for breast and cervical cancer.), As Introduced Honorable Gary VanDeaver, Chair, House Committee on Public Health Honorable Gary VanDeaver, Chair, House Committee on Public Health Jerry McGinty, Director, Legislative Budget Board Jerry McGinty, Director, Legislative Budget Board HB1782 by Howard (Relating to eligibility for Medicaid for breast and cervical cancer.), As Introduced HB1782 by Howard (Relating to eligibility for Medicaid for breast and cervical cancer.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB1782, As Introduced: a negative impact of ($1,674,063) through the biennium ending August 31, 2027. Estimated Two-year Net Impact to General Revenue Related Funds for HB1782, As Introduced: a negative impact of ($1,674,063) through the biennium ending August 31, 2027. General Revenue-Related Funds, Five- Year Impact: 2026 $0 2027 ($1,674,063) 2028 ($10,176,523) 2029 ($21,096,550) 2030 ($29,453,571) All Funds, Five-Year Impact: 2026 $0 $0 $0 $0 2027 ($1,914,486) ($2,851,473) $180,317 $60,106 2028 ($10,812,769) ($16,104,754) $477,185 $159,061 2029 ($22,188,161) ($33,047,491) $818,708 $272,903 2030 ($30,795,157) ($45,866,921) $1,006,190 $335,396 Fiscal Analysis The bill would require the Health and Human Services Commission (HHSC) to increase the income limit from 200 percent of the Federal Poverty Level (FPL) to 250 percent of the FPL for breast and cervical cancer services in the Medicaid program.The bill would take effect immediately if it receives a vote of two-thirds of all the members elected to each house. Otherwise, the bill would take effect September 1, 2025. Methodology HHSC assumes that services would begin September 1, 2026. The additional average monthly caseload associated with the bill is estimated to be 89 in fiscal year 2027, increasing to an average of 1,261 by fiscal year 2030. This analysis assumes a total client services cost of $1,914,486 from the General Revenue Fund ($4,765,959 from All Funds) in fiscal year 2027.This analysis assumes that these costs would be partially offset by an estimated $180,317 to the General Revenue Fund in fiscal year 2027 from client services payments through managed care that are assumed to result in an increase to the General Revenue Fund from insurance premium tax revenue and revenue adjusted for assumed timing of payments and prepayments, all of which results in increased revenue collections. Pursuant to Section 227.001(b), Insurance Code, 25 percent of the revenue collection is assumed to be deposited to the credit of the Foundation School Fund ($60,106 in fiscal year 2027).This analysis assumes that any additional costs associated with the bill could be absorbed using existing resources, including an estimated 5.5 FTEs in fiscal year 2026 and 6.5 FTEs in fiscal year 2027. Technology This analysis assumes that any technology costs associated with the bill could be absorbed using existing resources. Local Government Impact No significant fiscal implication to units of local government is anticipated. Source Agencies: b > td > 529 Health and Human Services Commission 529 Health and Human Services Commission LBB Staff: b > td > JMc, NPe, ER, ESch, NV JMc, NPe, ER, ESch, NV