HBA-MPM H.B. 2708 76(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2708 By: Coleman Public Health 3/24/1999 Introduced BACKGROUND AND PURPOSE Immigrant children who reside in the United States legally, but who entered the country after the passage of the federal welfare reform legislation on August 22, 1996, are ineligible under federal law for the state-federal Medicaid program and the state-federal Children's Health Insurance Program (CHIP) for a period of five years after their entry date. H.B. 2708 creates a state-only program modeled after CHIP to provide health benefits to these children for the duration of their ineligibility, if they otherwise meet the income and resource requirements for Medicaid or CHIP. This bill also authorizes a child to be required to share part of the cost of benefits received from the program. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. SECTION BY SECTION ANALYSIS SECTION 1. Amends Subtitle C, Title 2, Health and Safety Code, by adding Chapter 63, as follows: CHAPTER 63. HEALTH BENEFITS PLAN COVERAGE FOR CERTAIN CHILDREN Sec. 63.001. HEALTH BENEFITS PLAN COVERAGE FOR CERTAIN CHILDREN. Requires the Texas Department of Health (department) to develop and implement a program to provide health benefits plan coverage for children meeting specific criteria. Sec. 63.002. BENEFITS COVERAGE REQUIRED. Provides that to the extent possible, the program required by Section 63.001, Health and Safety Code (program), must provide benefits comparable to those provided under a program established by this state to implement 42 U.S.C., Section 1397aa, et seq. (Title XXI, Social Security Act), as amended. Sec. 63.003. HEALTH BENEFITS PLAN PROVIDER. (a) Provides that a health benefits plan provider (provider) under this chapter must hold a certificate of authority or other appropriate license issued by the Texas Department of Insurance authorizing the provider to provide the type of coverage to be offered through the program, and to satisfy, except as provided by Subsection (b), any other applicable requirement of the Insurance Code or another insurance law of this state. (b) Provides that a provider under this chapter is not subject to a law requiring coverage or the offer of coverage of a health care service or benefit, except as required by the department. Sec. 63.004. COST-SHARING PAYMENTS. (a) Prohibits the department, except as provided by Subsection (b), from requiring a child who is provided coverage under Section 63.001, Health and Safety Code, and who meets the income eligibility requirement of the medical assistance program under Chapter 32 (Medical Assistance Program), Human Resources Code, to pay a premium, deductible, coinsurance, or other cost-sharing payment as a condition of coverage under this chapter. (b) Authorizes the department to require a child described by Subsection (a) to pay a copayment as a condition of coverage under this chapter that is equal to any co-payment required under a program established by this state to implement 42 U.S.C., Section 1397aa et seq. (Title XXI, Social Security Act), as amended. (c) Authorizes the department to require a child who is provided coverage under Section 63.001, Health and Safety Code, and who meets the income eligibility requirement of a program established under 42 U.S.C., Section 1397aa et seq. (Title XXI, Social Security Act), as amended, to pay a premium, deductible, coinsurance, or other cost-sharing payment as a condition of coverage under this chapter. Provides that the payment must be equal to any premium, deductible, coinsurance, or other cost-sharing payment required under a program established by this state to implement 42 U.S.C., Section 1397aa et seq. (Title XXI, Social Security Act), as amended. Sec. 63.005. DISALLOWANCE OF MATCHING FUNDS FROM FEDERAL GOVERNMENT. Prohibits expenditures made to provide coverage under this section from being included for the purpose of determining the state children's health insurance expenditures, as that term is defined by 42 U.S.C., Section 1397ee (d)(2)(B) (Payments to States), as amended. SECTION 2. Effective date: September 1, 1999. SECTION 3. Requires the board to establish and implement the coverage program as added by this Act no later than September 1, 2000. SECTION 4. Requires the state to provide coverage under the state Medicaid program or under a program established under 42 U.S.C., Section 1397aa et seq. (Title XXI, Social Security Act), as amended, to a child described by Section 63.001, Health and Safety Code, as added by this Act, if the federal government authorizes the state to do so. Requires the Health and Human Services Commission or any other appropriate agency to comply with any prerequisites under federal law to provide the coverage. SECTION 5. Emergency clause.