By Madden H.B. No. 2554
74R6673 DLF-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to eligibility of certain persons for state subsidized
1-3 health care services.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Section 61.007, Health and Safety Code, is
1-6 amended to read as follows:
1-7 Sec. 61.007. INFORMATION PROVIDED BY APPLICANT. The
1-8 department by rule shall require each applicant to provide at least
1-9 the following information:
1-10 (1) the applicant's full name and address;
1-11 (2) the name and address of the applicant's employer,
1-12 if any;
1-13 (3) the applicant's social security number, if
1-14 available;
1-15 (4) <(3)> the number of persons in the applicant's
1-16 household, excluding persons receiving AFDC, SSI, or Medicaid
1-17 benefits;
1-18 (5) <(4)> the applicant's county of residence;
1-19 (6) <(5)> the existence of insurance coverage or other
1-20 hospital or health care benefits for which the applicant is
1-21 eligible;
1-22 (7) <(6)> any transfer of title to real property that
1-23 the applicant has made in the preceding 24 months;
1-24 (8) <(7)> the applicant's annual household income,
2-1 excluding the income of any household member receiving AFDC, SSI,
2-2 or Medicaid benefits; and
2-3 (9) <(8)> the amount of the applicant's liquid assets
2-4 and the equity value of the applicant's car and real property.
2-5 SECTION 2. Section 61.008, Health and Safety Code, is
2-6 amended by adding Subsections (c), (d), and (e) to read as follows:
2-7 (c) A person is not an eligible county resident or an
2-8 eligible resident if:
2-9 (1) the person is employed by an employer that offers
2-10 any type of health care coverage for its employees, including
2-11 coverage under:
2-12 (A) a group or individual health insurance
2-13 policy or contract;
2-14 (B) an evidence of coverage issued by a health
2-15 maintenance organization or group hospital service corporation; or
2-16 (C) an employee benefit plan;
2-17 (2) the employer would pay at least 50 percent of the
2-18 cost of the coverage for the employee;
2-19 (3) the person is eligible for coverage that would be
2-20 effective to cover the services for which payment is sought under
2-21 this chapter; and
2-22 (4) the person is not covered under the coverage
2-23 offered by the employer because the person refused that coverage.
2-24 (d) Subsection (c) does not apply to services provided in an
2-25 emergency.
2-26 (e) Subsection (c) does not apply to a person who, at the
2-27 time the person refused the coverage offered by the employer, was
3-1 covered by health care coverage offered by another employer, an
3-2 employer of a spouse, or otherwise.
3-3 SECTION 3. Chapter 285, Health and Safety Code, is amended
3-4 by adding Subchapter H to read as follows:
3-5 SUBCHAPTER H. PERSONS ELIGIBLE FOR HOSPITAL DISTRICT SERVICES
3-6 Sec. 285.091. CERTAIN PERSONS INELIGIBLE FOR SERVICES. A
3-7 hospital district created by general or special law may not provide
3-8 services to a person if:
3-9 (1) the person is employed by an employer that offers
3-10 any type of health care coverage for its employees, including
3-11 coverage under:
3-12 (A) a group or individual health insurance
3-13 policy or contract;
3-14 (B) an evidence of coverage issued by a health
3-15 maintenance organization or group hospital service corporation; or
3-16 (C) an employee benefit plan;
3-17 (2) the employer would pay at least 50 percent of the
3-18 cost of the coverage for the employee;
3-19 (3) the person is eligible for coverage that would be
3-20 effective to cover the services; and
3-21 (4) the person is not covered under the coverage
3-22 offered by the employer because the person refused that coverage.
3-23 Sec. 285.092. EXCEPTIONS. (a) Section 285.091 does not
3-24 apply to services provided to a person who:
3-25 (1) is eligible for medical assistance under the state
3-26 Medicaid program;
3-27 (2) pays for the services provided in full; or
4-1 (3) was covered, at the time the person refused the
4-2 coverage offered by the employer, by health care coverage offered
4-3 by another employer, an employer of a spouse, or otherwise.
4-4 (b) Section 285.091 does not apply to services provided in
4-5 an emergency.
4-6 SECTION 4. The Texas Department of Health shall adopt rules
4-7 as required by Section 61.007, Health and Safety Code, as amended
4-8 by this Act, not later than December 31, 1995.
4-9 SECTION 5. The importance of this legislation and the
4-10 crowded condition of the calendars in both houses create an
4-11 emergency and an imperative public necessity that the
4-12 constitutional rule requiring bills to be read on three several
4-13 days in each house be suspended, and this rule is hereby suspended,
4-14 and that this Act take effect and be in force from and after its
4-15 passage, and it is so enacted.