HBA-MSH, CCH C.S.H.B. 1156 77(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 1156 By: Coleman Public Health 3/29/2001 Committee Report (Substituted) BACKGROUND AND PURPOSE The Texas Department of Health (TDH) estimates that 164,000 women per year receive Medicaid-funded women's health services, which include physical examinations, laboratory testing, counseling on contraception, and breast and cervical cancer screening. To be eligible for these services, a woman must be less than 60 days postpartum and have a family income below 185 percent of the federal poverty level, or either be receiving financial assistance from the Temporary Assistance for Needy Families program, or be enrolled in a transitional Medicaid welfare-to-work program. TDH also approximates that an additional 300,000 women receive women's heath services funded by the family planning services project grant, the social services block grant, and the maternal and child health block grant. TDH estimates that an additional one million uninsured working women with family incomes at or below 185 percent of the federal poverty level do not have regular access to women's health services. Expanding Medicaid coverage for women's health services to all women between the ages of 13 and 44 years old with family incomes at or below 185 percent of the federal poverty level will allow an additional 600,000 women access to these services, according to TDH projections. TDH expects to realize cost savings through this expansion by averting Medicaid- funded pregnancies. C.S.H.B.1156 creates a women's health care demonstration project to expand access to preventive health and family planning services and prohibits the use of funds for abortion related activities. 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. ANALYSIS C.S.H.B. 1156 amends the Human Resources Code to require the Health and Human Services Commission (HHSC) to establish a five-year demonstration project through the medical assistance program to expand access to preventive health and family planning services for women. The bill provides that a women is eligible to participate in the demonstration project if she is of childbearing age, has a net family income that is at or below 185 percent of the federal poverty level, and is not otherwise eligible for the medical assistance program. The bill sets forth the services a participant may receive. The bill also requires HHSC to compile a list of potential funding sources a client can use to help pay for treatment for health problems identified using preventive health services provided under the medical assistance program for which the client is not eligible to receive treatment under the program. The bill requires HHSC to submit a report to the legislature not later than December 1 of each even-numbered year regarding HHSC's progress in establishing and operating the demonstration project. The project expires September 1, 2007. The bill prohibits the use of funds, either directly or indirectly, for abortion or abortion-related services unless allowed under federal law and regulation and requires HHSC to perform an audit to ensure compliance with the prohibition. EFFECTIVE DATE On passage, or if the Act does not receive the necessary vote, the Act takes effect September 1, 2001. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 1156 differs from the original by creating a women's health care demonstration project rather than changing the eligibility cap for medical assistance for preventive health and family planning services for women. The substitute also prohibits the use of funds for abortion or abortion-related activities and requires HHSC to perform an audit to ensure compliance with the prohibition. The substitute also requires HHSC to submit a progress report to the legislature every two years and provides that the project expires in 2007.