BILL ANALYSIS

H.B. 4253

By: Campos

Human Services

Committee Report (Unamended)

BACKGROUND AND PURPOSE

The Deficit Reduction Act of 1984 has for decades guaranteed automatic enrollment for babies born to Medicaid-enrolled mothers, beginning at birth and continuing uninterrupted through the first year of life. Despite this, many newborn babies are still missing out on Medicaid coverage. In a report published in January 2021, the Johnson Group Consulting, Inc., found that despite this federal law protection, more than 500,000 infants nationwide, including in Texas, are not counted as continuously eligible during their first year of life and are missing out on vital coverage. State data reported to the Centers for Medicare and Medicaid Services for 2018, indicated that nearly 64,000 Texas infants had their Medicaid coverage interrupted, despite the requirement that they be automatically eligible for a year. H.B. 4253 seeks to address this issue by providing for a study to assess the Health and Human Services Commission's compliance with federal guidelines and requirements on the mandated coverage of infants born to Medicaid-enrolled mothers.

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

H.B. 4253 requires the Health and Human Services Commission (HHSC) to conduct a study to assess its compliance with federal guidelines and requirements on the required coverage of certain infants under Medicaid. In conducting the study, HHSC must examine whether or the extent to which HHSC does the following:

· provides Medicaid coverage to infants born in Texas whose mother was a Medicaid recipient at the time of the birth;

· requires the submission of a separate application or eligibility determination for those infants;

· requires by rule or otherwise that such an infant reside with its mother to remain eligible for Medicaid;

· allows an infant to receive Medicaid coverage by using its mother’s Medicaid identification number from the period between the infant's birth until the infant reaches one year of age or, if the mother does not have a Medicaid identification number, provides a separate Medicaid identification number to the infant;

· requires proof of citizenship for an infant to receive Medicaid coverage before the infant reaches one year of age;

· ensures that an infant remains continuously eligible from the period between the infant's birth until the infant reaches at least one year of age, unless the infant dies, is moved outside of Texas, or is voluntarily disenrolled from Medicaid; and

· conducts an eligibility redetermination for infants before they reach one year of age.

H.B. 4253 requires HHSC, not later than September 1, 2024, to prepare and submit to the governor, the lieutenant governor, the speaker of the house of representatives, and the legislature a report that summarizes the results of the study and includes any legislative recommendations based on the results on how to improve Medicaid coverage rates and related requirements for eligible infants.

The bill's provisions expire September 1, 2025.   

EFFECTIVE DATE

September 1, 2023.