HBA-MPM, CCH S.B. 831 77(R) BILL ANALYSIS Office of House Bill AnalysisS.B. 831 By: Moncrief Public Health 4/16/2001 Engrossed BACKGROUND AND PURPOSE Some disabled individuals who are capable of working may choose not to work because they lose their Supplemental Security Income (SSI) and Medicaid eligibility if they earn more than a certain income. Often, people with disabilities who lose Medicaid benefits cannot afford private insurance plans. The federal Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA) authorizes states to allow people with disabilities to buy into the Medicaid program thereby removing an obstacle for them to sustain employment. Senate Bill 831 requires the Health and Human Services Commission to develop and implement a medical assistance buy-in pilot program under TWWIIA so that employed disabled individuals can receive Medicaid coverage. RULEMAKING AUTHORITY 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. ANALYSIS Senate Bill 831 amends the Human Resources Code to require the Health and Human Services Commission (HHSC) to develop and implement no later than January 1, 2002 a medical assistance buy-in pilot program (pilot program) in accordance with the federal Ticket to Work and Work Incentives Improvement Act of 1999. The pilot program is to provide medical assistance to a person who is between 16 and 64 years of age and has an earned income exceeding the limit to receive Social Security Income (SSI) but is otherwise eligible to receive SSI and to an employed individual with a medically improved disability, both of whom have income, assets, and resources that do not exceed limits established by HHSC as provided in this bill. The bill requires HHSC to operate the pilot program in three specific geographical areas of the state, each of which is located in a local workforce development area for which the local workforce development board has received a federal work incentive grant under the federal Workforce Investment Act of 1998 to provide employment services and supports to disabled persons. HHSC is required to determine the pilot sites, with one site in an urban area, one in a rural area, and one in the Texas-Mexico border region. S.B. 831 authorizes HHSC to establish income, assets, and resource limitations for participation in the pilot program. The bill provides that project participants may be required by HHSC to pay premiums and other cost-sharing charges based on income in accordance with federal welfare law. The bill requires HHSC, no later than December 1, 2002, to report to the presiding officer of each house of the legislature regarding the pilot program's effectiveness and the feasibility of expanding the program statewide. The pilot program expires September 1, 2003. EFFECTIVE DATE September 1, 2001.