LEGISLATIVE BUDGET BOARD Austin, Texas FISCAL NOTE 75th Regular Session May 23, 1997 TO: Honorable Bob Bullock IN RE: Senate Bill No. 54, As Passed 2nd House Lieutenant Governor Shapiro Senate Austin, Texas FROM: John Keel, Director In response to your request for a Fiscal Note on SB54 ( relating to access to certain obstetrical or gynecological health care under a health benefit plan; providing administrative penalties.) this office has detemined the following: Biennial Net Impact to General Revenue Funds by SB54-As Passed 2nd House Implementing the provisions of the bill would result in a net impact of $0 to General Revenue Related Funds through the biennium ending August 31, 1999. The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. Fiscal Analysis This bill would allow female health care plan participants direct and unlimited access to an obstetrician or gynecologist without referral by a primary care physician. The provisions of the bill also preclude health care plans from imposing a copayment or deductible for direct access to the services of an obstetrician or gynecologist unless a copayment or deductible is imposed for access to other heath care services provided under the plan. This bill would be applicable to health maintenance organizations (HMOs) participating in the state managed care system beginning January 1, 1998. As a result, the bill is expected to increase expenses to the Uniform Group Insurance Plan (UGIP) by $510,000 in fiscal year 1999, $535,000 in fiscal year 2000, $565,000 in fiscal year 2001, and $590,000 in fiscal year 2002. Methodolgy These increased costs to ERS were calculated by ERS' health actuary, under the following assumptions: 1. HMO premiums would increase as a result of providing the coverage that is required by the bill. 2. These increased premiums would increase expenses to UGIP. The probable fiscal implications of implementing the provisions of the bill during each of the first five years following passage is estimated as follows: Five Year Impact: Fiscal Year Probable Savings/(Cost) from Employee Life 0973 1998 1998 (510,000) 2000 (535,000) 2001 (565,000) 2002 (590,000) Net Impact on General Revenue Related Funds: Fiscal Year Probable Net Postive/(Negative) General Revenue Related Funds Funds 1998 $0 1999 0 2000 0 2001 0 2002 0 Similar annual fiscal implications would continue as long as the provisions of the bill are in effect. No significant fiscal implication to units of local government is anticipated. Source: Agencies: 327 Employees Retirement System LBB Staff: JK ,TH ,BK