BILL ANALYSIS



Public Health Committee
H.B. 997
By: Henry Cuellar
03-14-95
Committee Report (Amended)



BACKGROUND

Children not covered by Medicaid often are not given adequate
medical care when needed. Although parental resources exclude these
children from qualifying for Medicaid, the families are often too
poor to afford to visit a family doctor. Currently in Texas, many
children end up in hospital emergency rooms for nonemergency
medical treatment because the public hospitals in Texas do not turn
anyone away. The cost for this type of treatment, however, is
approximately three times higher than a visit to a doctor's office.

This legislation proposes establishing a pilot program to provide
primary-care health insurance coverage for children younger than 13
years of age who are not already covered under Medicaid. The
intention of this bill is to provide the program through local
public schools and use Florida's "Healthy Kids Corporation" as a
model. The Florida Legislature created the "Healthy Kids
Corporation" in 1990 to provide health insurance coverage through
participating public schools, with families paying a sliding fee
based on income.

PURPOSE

The bill requires the Texas Department of Health to establish a
pilot program to provide health insurance coverage for children
under age 13 who are ineligible for Medicaid and authorizes the
State Medicaid office to develop a waiver for such a pilot in one
area of the state.

RULEMAKING AUTHORITY

It is the committee's opinion that this bill grants additional rule
making authority to the Texas Department of Health in Section 1(c)
of this bill.

SECTION BY SECTION ANALYSIS

SECTION 1.  PILOT PROGRAM. This act creates a pilot program under
the auspices of the Texas Department of Health, with the following
provisions:

     (a) Requires the TDH to establish a pilot program to provide
     primary care health insurance coverage to eligible children.

     (b) Allows TDH to provide such a program through local public
     schools and to use the Florida "Healthy Kids Corporation" as
     a model.

     (c) Requires TDH, by rule, to prescribe eligibility criteria
     and set a sliding fee scale based on income.

     (d) Requires the TDH to report to the Governor and the 74th
     and 75th Legislatures about the success of the program.

     (e) Authorizes the State Medicaid program to develop a waiver
     for a pilot program, in one area of the state, which would
     provide access to health insurance to children whose parents
     do not have access to private insurance. Stipulates that
     existing federal, state or local funds and private monies will
     be used and prohibits the use of any new state funds. Requires
     the pilot to include sliding scale, cost-sharing by the family
     served.

SECTION 2. EFFECTIVE DATE AND EXPIRATION DATE; WAIVER.

     (a) Effective: September 1, 1995.

     (b) Expires: September 1, 1999.

     (c) If the TDH determines a waiver from a federal agency is
     necessary to implement the act, it must first be granted.

SECTION 3. Emergency clause.

EXPLANATION OF AMENDMENT

Committee Amendment 1 adds subsection (e) to Section 1 of this
bill, authorizing the State Medicaid program to establish a pilot
program which provides health insurance to children whose parents
do not have access to private health insurance and prohibiting the
use of any new state funds in establishing the program.

SUMMARY OF COMMITTEE ACTION

H.B. 997 was considered by the Public Health Committee in a public
hearing on February 28, 1995. The bill was left pending in
committee. The bill was considered in a public hearing on March 14,
1995, as pending business. The committee considered one amendment
to the bill. The amendment was adopted without objection.

The following persons testified for the bill:
Representative Henry Cuellar, author of the bill.
Dr. Clift Price, representing Texas Pediatric Society.
Lisa McGiffert, representing Consumers Union.

The following person testified neutrally on the bill:
David R. Smith, M.D., representing Texas Department of Health.

The bill was reported favorably as amended, with the recommendation
that it do pass and be printed, by a record vote of 8 Ayes, 0 Nays,
0 PNV, and 1 Absent.