Office of House Bill AnalysisH.B. 2807
By: Kitchen
Public Health


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.  There are a number of local initiatives that address the
health needs of low-income, uninsured adults who do not qualify for
Medicaid. Through a demonstration project, these initiatives could receive
federal matching funds to expand health coverage for low-income adults.
House Bill 2807 requires the Health and Human Services Commission to
establish such a demonstration project.  


It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 


House Bill 2807 amends the Human Resources Code to require the Health and
Human Services Commission (HHSC) to establish a demonstration project
(project) to provide Medicaid to an adult who meets the income eligibility
criteria set by HHSC, is not otherwise eligible for Medicaid, and is not
covered by a health benefits plan offering adequate coverage.  HHSC  is
required to establish a family income eligibility limit in conjunction with
local governmental agencies that make funds available to HHSC for 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 and to
design the components of the project including the adoption of procedures
for reporting and monitoring.  In establishing the project, HHSC is
required to ensure that the project is financed using funds made available
by certain local governmental entities, which may include a county indigent
health care program, to HHSC for matching purposes to maximize federal
funds for Medicaid and that a participant in the project is not subject to
a limitation of prescription drug benefits.  The bill specifies that the
manner in which a governmental entity makes funds available for matching
purposes must include an option for the entity to be able to certify the
amount of funds considered available instead of sending the funds to the

The bill requires the Texas Department of Health (TDH) to administer the
project at the direction of HHSC and requires HHSC to select one or more
municipalities or counties in which to implement the project. One selected
county must have a population of more than 725,000 or at least one
municipality must have a population of more than 600,000.  The bill
provides that the project may be implemented in a multicounty region and
may include local funds made available through a county indigent health
care program. HHSC is required to appoint an advisory committee that
includes health care providers and local government officials to assist
HHSC and TDH in establishing and implementing the project. TDH is required
to implement the project no later than January 1, 2002.  The bill requires
TDH to evaluate and report to the legislature on the operation and
cost-effectiveness of the project no later than December 1  of each
even-numbered year.