SRC-CTC H.B. 2807 77(R) BILL ANALYSIS Senate Research Center H.B. 2807 By: Kitchen (Barrientos) Health & Human Services 5/10/2001 Engrossed DIGEST AND PURPOSE Texas has enacted many laws that address the provision of health coverage for its uninsured children. However, low-income adults are often unable to obtain affordable, quality health care. Workers in families that fall below 200 percent of the federal poverty level are less likely to receive health insurance through their employer. More than two-thirds of uninsured, non-retired adults age 18 and older, have a job. A January 1999 poll conducted by the W.K. Kellogg Foundation indicated that 86 percent of Americans believe that working poor families should have access to health care coverage. Currently, there are a number of local initiatives that address the health needs of low-income, uninsured adults who do not qualify or Medicaid. Through a demonstration project, these initiatives could receive federal matching funds to expand health coverage for low-income adults. H.B. 2807 requires the Health and Human Services Commission to establish such a demonstration project. RULEMAKING AUTHORITY This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency. SECTION BY SECTION ANALYSIS SECTION 1. Amends Chapter 32B, Human Resources Code, by adding Section 32.053, as follows: Sec. 32.053. DEMONSTRATION PROJECT FOR PROVISION OF MEDICAL ASSISTANCE TO CERTAIN LOW-INCOME INDIVIDUALS. (a) Requires the Health and Human Services Commission (HHS) to establish a project to provide medical assistance under this chapter to certain adult individuals. (b) Requires HHS, in conjunction with local governmental entities that make funds available to HHS in accordance with this section, to establish a family income eligibility limit for individuals participating in the project so that only an individual whose family income is at or below 200 percent of the federal poverty level is eligible for participation in the project. (c) Requires HHS, in conjunction with local governmental entities that make funds available to the commission in accordance with this section, to design the components of the project, including the adoption of certain procedures for reporting and monitoring. (d) Sets forth certain requirements of HHS in establishing the project. (e) Requires the manner in which a local governmental entity makes funds available for matching purposes under Subsection (d)(1) to include an option for the entity to be able to certify the amount of funds considered available instead of sending the funds to the state. (f) Requires the Texas Department of Health (TDH) to administer the project at the direction of HHS. (g) Requires HHS to select one or more municipalities or counties in which to implement the project, and at least one selected county must have a population of more than 725,000 or at least one selected municipality must have a population of more than 600,000. Authorizes the project to be implemented in a multi-county region and to include local funds made available through a county indigent health care program. (h) Requires HHS to appoint an advisory committee to assist HHS and TDH in establishing and implementing the project. Requires the advisory committee to include health care providers and local government officials. (i) Requires TDH, not later than December 1 of each even-numbered year, to evaluate the effectiveness, including the cost-effectiveness, of the project in providing health care services to project participants. Requires TDH, if the results of the evaluation indicate that the project is cost-effective, to incorporate a request for funding for the continuation or expansion of the project in TDH's budget request for the next state fiscal biennium. (j) Requires TDH, not later than December 1 of each even-numbered year, to submit a report to the legislature regarding the operation and cost-effectiveness of the project established under this section. SECTION 2. Requires HHS, if HHS determines that a waiver or authorization from a federal agency is necessary for implementing any provision of this Act, to request the waiver or authorization not later than September 1, 2001, and authorizes HHS to delay implementing that provision until the waiver or authorization is granted. SECTION 3. Requires TDH to implement the project required by Section 32.053, Human Resources Code, as added by this Act, not later than January 1, 2002. SECTION 4. Effective date: upon passage or September 1, 2001.