LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION March 16, 2025 TO: Honorable Stan Lambert, Chair, House Committee on Pensions, Investments & Financial Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB618 by Walle (Relating to health benefit plan coverage of certain in vitro fertilization procedures for certain governmental employees and retirees.), As Introduced Estimated Two-year Net Impact to General Revenue Related Funds for HB618, As Introduced: a negative impact of ($4,339,227) through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. General Revenue-Related Funds, Five- Year Impact: Fiscal Year Probable Net Positive/(Negative) Impact toGeneral Revenue Related Funds2026$02027($4,339,227)2028($4,628,046)2029($4,936,089)2030($5,264,634)All Funds, Five-Year Impact: Fiscal Year Probable (Cost) fromGeneral Revenue Fund1 Probable Savings/(Cost) fromGR Dedicated Accounts994 Probable Savings/(Cost) fromFederal Funds555 Probable Savings/(Cost) fromOther Special State Funds9982026$0$0$0$02027($4,339,227)($356,402)($1,128,415)($94,502)2028($4,628,046)($380,124)($1,203,522)($100,792)2029($4,936,089)($405,425)($1,283,628)($107,501)2030($5,264,634)($432,410)($1,369,067)($114,656)Fiscal Year Probable Savings/(Cost) fromState Highway Fund6 Probable Savings/(Cost) fromSchool Employees UGIP Trust Fund8552026$0$02027($714,027)($10,491,198)2028($761,553)($11,015,757)2029($812,242)($11,566,545)2030($866,304)($12,144,873) Fiscal AnalysisThe bill would amend portions of the Insurance Code to require certain government health benefit plans to include coverage for outpatient expenses that arise from in vitro fertilization procedures to the same extent that those plans provide benefits for certain other pregnancy-related procedures.The bill would take effect September 1, 2025 and would apply to plans delivered, issued for delivery, or renewed on or after January 1, 2026.
LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 89TH LEGISLATIVE REGULAR SESSION
March 16, 2025
TO: Honorable Stan Lambert, Chair, House Committee on Pensions, Investments & Financial Services FROM: Jerry McGinty, Director, Legislative Budget Board IN RE: HB618 by Walle (Relating to health benefit plan coverage of certain in vitro fertilization procedures for certain governmental employees and retirees.), As Introduced
TO: Honorable Stan Lambert, Chair, House Committee on Pensions, Investments & Financial Services
FROM: Jerry McGinty, Director, Legislative Budget Board
IN RE: HB618 by Walle (Relating to health benefit plan coverage of certain in vitro fertilization procedures for certain governmental employees and retirees.), As Introduced
Honorable Stan Lambert, Chair, House Committee on Pensions, Investments & Financial Services
Honorable Stan Lambert, Chair, House Committee on Pensions, Investments & Financial Services
Jerry McGinty, Director, Legislative Budget Board
Jerry McGinty, Director, Legislative Budget Board
HB618 by Walle (Relating to health benefit plan coverage of certain in vitro fertilization procedures for certain governmental employees and retirees.), As Introduced
HB618 by Walle (Relating to health benefit plan coverage of certain in vitro fertilization procedures for certain governmental employees and retirees.), As Introduced
Estimated Two-year Net Impact to General Revenue Related Funds for HB618, As Introduced: a negative impact of ($4,339,227) through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
Estimated Two-year Net Impact to General Revenue Related Funds for HB618, As Introduced: a negative impact of ($4,339,227) through the biennium ending August 31, 2027. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
General Revenue-Related Funds, Five- Year Impact:
2026 $0
2027 ($4,339,227)
2028 ($4,628,046)
2029 ($4,936,089)
2030 ($5,264,634)
All Funds, Five-Year Impact:
2026 $0 $0 $0 $0
2027 ($4,339,227) ($356,402) ($1,128,415) ($94,502)
2028 ($4,628,046) ($380,124) ($1,203,522) ($100,792)
2029 ($4,936,089) ($405,425) ($1,283,628) ($107,501)
2030 ($5,264,634) ($432,410) ($1,369,067) ($114,656)
2026 $0 $0
2027 ($714,027) ($10,491,198)
2028 ($761,553) ($11,015,757)
2029 ($812,242) ($11,566,545)
2030 ($866,304) ($12,144,873)
Fiscal Analysis
The bill would amend portions of the Insurance Code to require certain government health benefit plans to include coverage for outpatient expenses that arise from in vitro fertilization procedures to the same extent that those plans provide benefits for certain other pregnancy-related procedures.The bill would take effect September 1, 2025 and would apply to plans delivered, issued for delivery, or renewed on or after January 1, 2026.
The bill would take effect September 1, 2025 and would apply to plans delivered, issued for delivery, or renewed on or after January 1, 2026.
Methodology
The Employees Retirement System of Texas (ERS) estimates 550 women each year would be affected by the provisions of the bill, with an average cost per claimant of $17,500, resulting in an annual cost of $9.6 million to state agencies, community supervision and corrections departments, and institutions of higher education. According to ERS, the costs to general state agencies and community supervision and corrections departments is anticipated to be $6.6 million in the first year of impact and increase in subsequent years due to estimated annual enrollment growth of 1.0 percent and estimated annual medical costs growth of 5.6 percent. Since the bill applies to plans issued or renewed after January 1, 2026, ERS estimates the first year of impact to be fiscal year 2027. Costs from General Revenue funds for institutions of higher education are not anticipated to be significant, and therefore are not included in cost estimates for the bill. The Teacher Retirement System (TRS) assumes that approximately 1.0 percent of certain female healthcare plan members would be eligible coverage, and that costs would increase by 5 percent per fiscal year, according to medical trends. TRS estimates that the annual cost to ActiveCare, paid for out of School Employees UGIP Trust Fund 855, would be approximately $10.5 million beginning in fiscal year 2027, increasing to $12.1 million in fiscal year 2030. Additional costs would not increase the statutorily-required state contributions to ActiveCare for the 2026-27 biennium; therefore, no significant fiscal impact to the General Revenue Fund is anticipated. However, the additional costs may result in the need for higher contribution rates from the state, employers, or members. The costs to implement provisions of the bill for the TRS retiree healthcare program, TRS-Care, could be absorbed using existing resources. Based on information provided by The University of Texas System, implementation of the bill could impact medical plans resulting in a significant cost to institutional funds. Institutional funds are not appropriated in the General Appropriations Act, and therefore not a cost to the state.
Local Government Impact
The additional costs to TRS-ActiveCare may result in the need for additional contributions from school district employers and employees.
Source Agencies: b > td > 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
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, FV, LCO, JPO, NV, ENA
JMc, FV, LCO, JPO, NV, ENA