By Maxey H.B. No. 1656
76R5494 KLA-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to health benefits plan coverage for certain children.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Subtitle C, Title 2, Health and Safety Code, is
1-5 amended by adding Chapter 63 to read as follows:
1-6 CHAPTER 63. HEALTH BENEFITS PLAN COVERAGE FOR CERTAIN CHILDREN
1-7 Sec. 63.001. HEALTH BENEFITS PLAN COVERAGE FOR CERTAIN
1-8 CHILDREN. The department shall develop and implement a program to
1-9 provide health benefits plan coverage for a child who:
1-10 (1) is a qualified alien, as that term is defined by 8
1-11 U.S.C. Section 1641(b);
1-12 (2) is younger than 19 years of age;
1-13 (3) entered the United States after August 22, 1996;
1-14 (4) has resided in the United States for less than
1-15 five years; and
1-16 (5) meets the income eligibility requirement of, but
1-17 is not eligible for assistance under:
1-18 (A) a program established under Title XXI of the
1-19 Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended;
1-20 or
1-21 (B) the medical assistance program under Chapter
1-22 32, Human Resources Code.
1-23 Sec. 63.002. BENEFITS COVERAGE REQUIRED. To the extent
1-24 possible, the program required by Section 63.001 must provide
2-1 benefits comparable to the benefits provided under a program
2-2 established by this state to implement Title XXI of the Social
2-3 Security Act (42 U.S.C. Section 1397aa et seq.), as amended.
2-4 Sec. 63.003. HEALTH BENEFITS PLAN PROVIDER. (a) A health
2-5 benefits plan provider under this chapter must:
2-6 (1) hold a certificate of authority or other
2-7 appropriate license issued by the Texas Department of Insurance
2-8 that authorizes the health benefits plan provider to provide the
2-9 type of coverage to be offered through the program required by
2-10 Section 63.001; and
2-11 (2) satisfy, except as provided by Subsection (b), any
2-12 other applicable requirement of the Insurance Code or another
2-13 insurance law of this state.
2-14 (b) Except as required by the department, a health benefits
2-15 plan provider under this chapter is not subject to a law that
2-16 requires coverage or the offer of coverage of a health care service
2-17 or benefit.
2-18 Sec. 63.004. COST-SHARING PAYMENTS. (a) Except as provided
2-19 by Subsection (b), the department may not require a child who is
2-20 provided health benefits plan coverage under Section 63.001 and who
2-21 meets the income eligibility requirement of the medical assistance
2-22 program under Chapter 32, Human Resources Code, to pay a premium,
2-23 deductible, coinsurance, or other cost-sharing payment as a
2-24 condition of health benefits plan coverage under this chapter.
2-25 (b) The department may require a child described by
2-26 Subsection (a) to pay a co-payment as a condition of health
2-27 benefits plan coverage under this chapter that is equal to any
3-1 co-payment required under a program established by this state to
3-2 implement Title XXI of the Social Security Act (42 U.S.C. Section
3-3 1397aa et seq.), as amended.
3-4 (c) The department may require a child who is provided
3-5 health benefits plan coverage under Section 63.001 and who meets
3-6 the income eligibility requirement of a program established under
3-7 Title XXI of the Social Security Act (42 U.S.C. Section 1397aa et
3-8 seq.), as amended, to pay a premium, deductible, coinsurance, or
3-9 other cost-sharing payment as a condition of health benefits plan
3-10 coverage under this chapter. The payment must be equal to any
3-11 premium, deductible, coinsurance, or other cost-sharing payment
3-12 required under a program established by this state to implement
3-13 Title XXI of the Social Security Act (42 U.S.C. Section 1397aa et
3-14 seq.), as amended.
3-15 Sec. 63.005. DISALLOWANCE OF MATCHING FUNDS FROM FEDERAL
3-16 GOVERNMENT. Expenditures made to provide health benefits plan
3-17 coverage under this section may not be included for the purpose of
3-18 determining the state children's health insurance expenditures, as
3-19 that term is defined by 42 U.S.C. Section 1397ee(d)(2)(B), as
3-20 amended.
3-21 SECTION 2. This Act takes effect September 1, 1999.
3-22 SECTION 3. Not later than September 1, 2000, the Texas Board
3-23 of Health shall establish and implement the health benefits plan
3-24 coverage program required by Chapter 63, Health and Safety Code, as
3-25 added by this Act.
3-26 SECTION 4. The state shall provide coverage under the state
3-27 Medicaid program or under a program established under Title XXI of
4-1 the Social Security Act (42 U.S.C. Section 1397aa et seq.), as
4-2 amended, to a child described by Section 63.001, Health and Safety
4-3 Code, as added by this Act, if the federal government authorizes
4-4 the state to provide that coverage. The Health and Human Services
4-5 Commission or any other appropriate agency shall comply with any
4-6 prerequisites under the federal law to providing the coverage.
4-7 SECTION 5. The importance of this legislation and the
4-8 crowded condition of the calendars in both houses create an
4-9 emergency and an imperative public necessity that the
4-10 constitutional rule requiring bills to be read on three several
4-11 days in each house be suspended, and this rule is hereby suspended.