SRC-AXB C.S.S.B. 377 76(R)BILL ANALYSIS


Senate Research CenterC.S.S.B. 377
76R13104  AJA-DBy: Nelson
Health Services
4/21/1999
Committee Report (Substituted)


DIGEST 

Currently, Texas, which has over 60 mandates, leads the nation in the total
number of health insurance mandates.  Health insurance mandates are laws
which require insurers and managed care plans to provide specific benefits,
treatments, or reimbursement to certain health care providers. These
mandates drive up health insurance costs, and for every one percent
increase in premiums, 16,000 Texans lose health insurance coverage.
C.S.S.B. 377 requires the comptroller to perform cost-benefit studies of
health care benefit mandates, and requires the commissioner of insurance to
adopt rules to implement a health care benefit mandate. 

PURPOSE

As proposed, C.S.S.B. 377 creates review requirements for health care
benefit mandates, and authorizes the commissioner of insurance to adopt
rules to implement a health care benefit mandate. 

RULEMAKING AUTHORITY

Rulemaking authority is granted to the commissioner of insurance in SECTION
1 (Article 3.97-6. (a), Insurance Code), and to the house of
representatives and the senate in SECTION 1 (Article 3.973(a), Insurance
Code) of this bill. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Chapter 3, Insurance Code, by adding Subchapter K, as
follows: 

SUBCHAPTER K.  REVIEW AND IMPLEMENTATION OF HEALTH CARE BENEFIT MANDATES

Art.  3.97-1.  APPLICATION OF SUBCHAPTER.  Sets forth entities which offer
health benefit plans that are subject to the regulations of this
subchapter.  Sets forth plans and policies to which this subchapter does
not apply. 

Art.  3.97-2.  DEFINITIONS.  Defines "health benefit plan," "health care
benefit mandate," (HC mandate) and "offer of coverage mandate." 

Art.  3.97-3.  ANALYSIS BY COMPTROLLER.  Authorizes certain authorities to
request that the comptroller provide a written analysis of a proposed HC
mandate.  Authorizes the house of representatives and the senate to adopt
rules establishing procedures for requesting and considering an analysis.
Requires the comptroller to analyze the existing or proposed HC mandate,
and sets forth required considerations of the analysis. 

Art.  3.97-4.  REPORT ON EXISTING HEALTH CARE BENEFIT MANDATES.  Requires
the comptroller to review and analyze HC mandates by their effective date
of January 1, 2001.  Requires the comptroller to issue a written report of
the comptroller's findings and distribute the report to certain
authorities, and requires the publication of the report on the Internet.
Provides that this article expires December 31, 2001. 

Art.  3.97-5.  ASSESSMENTS.  Requires the comptroller to determine a rate
of assessment by January 1, each year.  Sets forth requirements for the
payment of an assessment, and sets  forth premiums or gross revenues which
are not included.  Provides that the required assessment is in addition to
other imposed taxes, and is not in conflict with this article. Requires the
comptroller to adjust the rate of assessments annually, as necessary to pay
for certain expenses.  Sets forth requirements for the deposit of and
spending of assessments collected under this article.  Provides that this
article expires September 1, 2003. 

Art.  3.97-6.  IMPLEMENTATION BY COMMISSIONER.  Requires the commissioner
of insurance to strictly construe an HC mandate, and to adopt rules to
implement an HC mandate in strict compliance with Texas and federal law.
Requires the commissioner of insurance to consider the comptroller's
analysis in adopting rules, and to prepare an HC mandate prior to
publishing rules which implement the mandate. 
 
SECTION 2.  Effective date:  September 1, 1999.

SECTION 3.  Emergency clause.

SUMMARY OF COMMITTEE CHANGES

SECTION 1.

Adds a new Article 3.97-1, Insurance Code, regarding the application of
this subchapter, and redesignates subsequent articles. 

Amends Article 3.97-2, Insurance Code, to redefine "health benefit plan" to
mean a plan to which this subchapter applies.  

Amends Article 3.97-3, Insurance Code, to authorize, rather than require,
the comptroller to provide a written analysis, grant rulemaking authority
to the house of representatives and the senate, and make nonsubstantive
changes. 

 Amends Article 3.97-4, Insurance Code, to make conforming changes.

Amends Article 3.97-5, Insurance Code, to delete the proposed section
regarding assessments and add new text specifying the comptroller's role in
determining the rate of assessment to cover the analysis and preparation of
the required written analysis.