Texas Senate Bill SB289

Texas 2025 - 89th Regular

• Filed: 11/12/24

Caption

Relating to a "Texas solution" to reforming and addressing issues related to the Medicaid program, including the creation of an alternative program designed to ensure health benefit plan coverage to certain low-income individuals through the private marketplace; requiring a fee.

Impact

Should SB289 be enacted, it would significantly modify existing state Medicaid laws, introducing a risk-based Medicaid managed care model. This change aims to simplify eligibility requirements for acute care services while providing subsidies to help low-income individuals acquire private health insurance. Furthermore, the bill mandates the development of a tailored support system for long-term services and care, fostering a consumer-directed approach to healthcare that prioritizes flexibility and cost-effectiveness.

Summary

SB289, titled 'Texas Solution to Medicaid Reform', seeks to address Medicaid program challenges by introducing an alternative program aimed at providing health benefit plan coverage for low-income individuals through a private marketplace. The proposed legislation comprises a comprehensive approach that permits the establishment of a block grant funding system, contingent upon federal approval, allowing Texas to customize its Medicaid program while aiming for cost neutrality through strategic funding mechanisms.

Contention

Debate surrounding SB289 hinges on its implications for healthcare accessibility and safety nets. Supporters assert that the bill offers an innovative way to deliver Medicaid services, promoting efficiency and consumer choice. However, critics express concern over the potential risks of privatizing essential health services and the lack of guaranteed entitlements within the framework, fearing increased barriers to access for the most vulnerable populations. The outcome of these discussions will be pivotal in shaping the future structure of health care delivery to low-income Texans.

Texas Constitutional Statutes Affected

Government Code

• Chapter 532. Medicaid Administration And Operation In General
  • Section: New Section

• Chapter 546. Long-term Care And Support Options For Individuals With Disabilities And Elderly Individuals
  • Section: New Section

Human Resources Code

• Chapter 32. Medical Assistance Program
  • Section: New Section