HBA-NMO H.B. 1696 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 1696 By: Coleman Public Health 3/29/1999 Introduced BACKGROUND AND PURPOSE Currently, the largest group of the estimated 1.4 million children in this state that do not have health insurance coverage are those children from low-income working families. Many of these children are not eligible for Medicaid or other public programs, and their parents may not have access to employer-based coverage. In an effort to increase the number of children with health insurance coverage, Congress has provided $48 billion over the next ten years through the Balanced Budget Act of 1997, under Title XXI of the Social Security Act, for the development of states' children's health insurance programs. In consideration of this provision, the recommendations of the Interim House Committee on Public Health include the implementation of Phase II of a state-designed Children's Health Insurance Program (CHIP) under Title XXI of the Social Security Act. H.B. 1696 requires the Health and Human Services Commission (HHSC) to develop a statedesigned CHIP to obtain health benefits coverage for children in low-income families. This bill also requires HHSC to ensure that CHIP is designed and administered in a manner that qualifies it for federal funding and uses the same resources that are used to administer the state Medicaid program. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Health and Human Services Commission in SECTION 1 (Section 62.003, Health and Safety Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subtitle C, Title 2, Health and Safety Code, by adding Chapter 62, as follows: CHAPTER 62. CHILD HEALTH PLAN FOR CERTAIN LOW-INCOME CHILDREN Sec. 62.001. DEFINITION. Defines "commission" as the Health and Human Services Commission (HHSC). Sec. 62.002. DUTIES OF COMMISSION. (a) Requires HHSC to develop a state-designed child health plan program (program) to obtain health benefits coverage for children in lowincome families. Requires HHSC to ensure that the program is designed and administered in a manner that qualifies it for federal funding under Title XXI of the Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended, and any other applicable law or regulations. (b) Requires HHSC to ensure that the program is operated using the same resources that are used to administer the state Medicaid program. (c) Requires HHSC to establish eligibility requirements to receive health benefits coverage under the child health plan (plan) that include an income eligibility level not lower than 200 percent of the federal poverty level, unless a lower level is required under the applicable federal law or regulations; that are consistent with Title XXI of the Social Security Act, as amended, and any other applicable law or regulations; and that are established subject to the availability of appropriated money. Sec. 62.003. RULES. Authorizes HHSC to adopt rules as necessary to implement this chapter. Sec. 62.004. APPLICATION OF INSURANCE LAW TO STATE CHILD HEALTH PLAN. Provides that the plan, to provide the flexibility necessary to satisfy the requirements of Title XXI of the Social Security Act, as amended, and any other applicable law or regulations, is not subject to a law that requires coverage or the offer of coverage of a health care service or benefit, coverage or the offer of coverage for the provision of services by a particular health care services provider, or the use of a particular policy, contract form or particular language in a policy or contract form. SECTION 2. Amends Section 4, Article 3.51-6, Insurance Code, to make conforming change relating to codification. SECTION 3. Requires HHSC, if before implementing any provision of Chapter 62 it determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, to request the waiver or authorization and authorizes it to delay implementing that provision until the waiver or authorization is granted. SECTION 4.Emergency clause. Effective date: upon passage.