By Madden H.B. No. 1368
75R2762 SAW-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to eligibility for publicly subsidized health care
1-3 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 applicant's social security number, if
1-12 available;
1-13 (3) the number of persons in the applicant's
1-14 household, excluding persons receiving AFDC, SSI, or Medicaid
1-15 benefits;
1-16 (4) the applicant's county of residence;
1-17 (5) the existence of insurance coverage or other
1-18 hospital or health care benefits for which the applicant is
1-19 eligible;
1-20 (6) the name and address of the applicant's employer,
1-21 if the applicant is employed;
1-22 (7) if the applicant is employed, whether the
1-23 applicant has rejected comprehensive health care benefits offered
1-24 by the employer at no cost to the applicant;
2-1 (8) [(6)] any transfer of title to real property that
2-2 the applicant has made in the preceding 24 months;
2-3 (9) [(7)] the applicant's annual household income,
2-4 excluding the income of any household member receiving AFDC, SSI,
2-5 or Medicaid benefits; and
2-6 (10) [(8)] the amount of the applicant's liquid assets
2-7 and the equity value of the applicant's car and real property.
2-8 SECTION 2. Section 61.008, Health and Safety Code, is
2-9 amended by adding Subsections (c) and (d) to read as follows:
2-10 (c) A person or a person's dependent is not an eligible
2-11 county resident or eligible resident if:
2-12 (1) an employer offers comprehensive health benefit
2-13 plan coverage for the person or the person's dependent, including
2-14 coverage under:
2-15 (A) a group or individual health insurance
2-16 policy or contract;
2-17 (B) an evidence of coverage issued by a health
2-18 maintenance organization or group hospital service corporation; or
2-19 (C) an employee benefit plan;
2-20 (2) the employer would pay the entire cost of the
2-21 health benefit plan coverage for the person or the person's
2-22 dependent; and
2-23 (3) the person or the person's dependent does not have
2-24 coverage under the health benefit plan offered by the employer
2-25 because the person refused the coverage.
2-26 (d) Subsection (c) does not apply to a person or a person's
2-27 dependent who:
3-1 (1) receives emergency services; or
3-2 (2) had coverage under another health benefit plan at
3-3 the time the person refused the coverage offered by the employer.
3-4 SECTION 3. Chapter 285, Health and Safety Code, is amended
3-5 by adding Subchapter K to read as follows:
3-6 SUBCHAPTER K. ELIGIBILITY FOR HOSPITAL DISTRICT SERVICES
3-7 Sec. 285.201. CERTAIN PERSONS INELIGIBLE FOR SUBSIDIZED
3-8 SERVICES. (a) A hospital district created by general or special
3-9 law may not provide publicly subsidized health care services to a
3-10 person or a person's dependent if:
3-11 (1) an employer offers comprehensive health benefit
3-12 plan coverage for the person or the person's dependent, including
3-13 coverage under:
3-14 (A) a group or individual health insurance
3-15 policy or contract;
3-16 (B) an evidence of coverage issued by a health
3-17 maintenance organization or group hospital service corporation; or
3-18 (C) an employee benefit plan;
3-19 (2) the employer would pay the entire cost of the
3-20 health benefit plan coverage for the person or the person's
3-21 dependent; and
3-22 (3) the person or the person's dependent does not have
3-23 coverage under the health benefit plan offered by the employer
3-24 because the person refused the coverage.
3-25 (b) Subsection (a) does not apply to a person or a person's
3-26 dependent who:
3-27 (1) receives emergency services; or
4-1 (2) had coverage under another health benefit plan at
4-2 the time the person refused the coverage offered by the employer.
4-3 SECTION 4. Subchapter B, Chapter 32, Human Resources Code,
4-4 is amended by adding Section 32.0242 to read as follows:
4-5 Sec. 32.0242. EMPLOYER PAID HEALTH BENEFIT PLAN COVERAGE.
4-6 (a) A person is ineligible for medical assistance, including
4-7 transitional medical assistance, under this chapter if:
4-8 (1) an employer offers comprehensive health benefit
4-9 plan coverage for the person or the person's dependent, including
4-10 coverage under:
4-11 (A) a group or individual health insurance
4-12 policy or contract;
4-13 (B) an evidence of coverage issued by a health
4-14 maintenance organization or group hospital service corporation; or
4-15 (C) an employee benefit plan;
4-16 (2) the employer would pay the entire cost of the
4-17 health benefit plan coverage for the person or the person's
4-18 dependent; and
4-19 (3) the person or the person's dependent does not have
4-20 coverage under the health benefit plan offered by the employer
4-21 because the person refused the coverage.
4-22 (b) Subsection (a) does not apply to a person or a person's
4-23 dependent who:
4-24 (1) receives emergency services; or
4-25 (2) had coverage under another health benefit plan at
4-26 the time the person refused the coverage offered by the employer.
4-27 SECTION 5. If before implementing a provision of this Act
5-1 the Health and Human Services Commission determines that a waiver
5-2 or authorization from a federal agency is necessary for
5-3 implementation, the commission shall request the waiver or
5-4 authorization and may delay implementing the provision until the
5-5 waiver or authorization is granted.
5-6 SECTION 6. (a) This Act takes effect September 1, 1997, and
5-7 applies only to publicly subsidized health care services provided
5-8 on or after January 1, 1998, regardless of the date on which
5-9 eligibility for those services is determined. Publicly subsidized
5-10 health care services provided before that date are governed by the
5-11 law as it existed immediately before the effective date of this
5-12 Act, and that law is continued in effect for that purpose.
5-13 (b) The Texas Department of Health and the Health and Human
5-14 Services Commission shall adopt rules to implement this Act not
5-15 later than December 31, 1997.
5-16 SECTION 7. The importance of this legislation and the
5-17 crowded condition of the calendars in both houses create an
5-18 emergency and an imperative public necessity that the
5-19 constitutional rule requiring bills to be read on three several
5-20 days in each house be suspended, and this rule is hereby suspended.