BILL ANALYSIS

C.S.H.B. 4080

By: Leo-Wilson

Insurance

Committee Report (Substituted)

BACKGROUND AND PURPOSE

The University of Texas Medical Branch (UTMB) Multi-Share Plan is a program that offers members the opportunity for basic health coverage to mitigate the inappropriate use of local emergency department care or no care at all. The UTMB Multi-Share Plan provides a set number of physician, urgent care, and emergency room visits, outpatient procedures, inpatient days, and ancillary needs, such as imaging and laboratory services. Funding for the program is made up of three components, hence the 3-Share concept: employer contribution, employee contribution, and the Texas Department of Insurance grant funding contribution. The program has an enrollment cap of 500 members at any given time, as UTMB Health is financially at risk for all claims above the amount of premium generated. Given that this program is designed to reinvest all premium dollars collected into the administration and benefits, there is a very small program team and modest budget. It has been suggested that if required to meet the price transparency regulations, this program would no longer be viable given the anticipated costs and resources required to maintain such compliance. The cost to implement and sustain the program would not be provided through premium or from grant dollars. C.S.H.B. 4080 seeks to exempt the UTMB Multi-Share Plan from certain regulatory requirements relating to health care cost disclosures.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.

ANALYSIS

C.S.H.B. 4080 amends the Insurance Code to exempt a regional or local health care program that contracts with health care providers within the boundaries of the participating county or counties to provide services directly to the employees of participating small employers and those employees' dependents from statutory provisions requiring health care cost disclosures by health benefit plan issuers and administrators.

EFFECTIVE DATE

September 1, 2023.

COMPARISON OF INTRODUCED AND SUBSTITUTE

C.S.H.B. 4080 differs from the introduced only by including a Texas Legislative Council draft number in the footer.