LEGISLATIVE BUDGET BOARD
Austin, Texas
FISCAL NOTE, 77th Regular Session
February 28, 2001
TO: Honorable Patricia Gray, Chair, House Committee on Public
Health
FROM: John Keel, Director, Legislative Budget Board
IN RE: HB1422 by Oliveira (Relating to the provision of medical
assistance to certain legal immigrants.), As Introduced
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* The Estimated Two-year Net Impact to General Revenue Related Funds *
* for HB1422, As Introduced: Scenario 1 would have a negative *
* impact of $(2,945,428), and Scenario 2 a negative impact of *
* $(3,569,877) through the biennium ending August 31, 2003. *
* *
* The bill would make no appropriation but could provide the legal *
* basis for an appropriation of funds to implement the provisions of *
* the bill. *
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All Funds, Five-Year Impact:
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*Fiscal Probable Savings/(Cost) from GR Probable Savings/(Cost) from *
* Year Match for Medicaid Federal Funds - Federal *
* 0758 0555 *
* 2002 $(683,766) $(1,034,240) *
* 2003 (2,261,662) (3,403,824) *
* 2004 (3,611,187) (5,432,607) *
* 2005 (4,958,749) (7,459,856) *
* 2006 (6,306,311) (9,487,105) *
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Scenario 1, above, assumes implementation of Section 1 (a) of the bill
only. Scenario 2, below, assumes implementation of the provisions of
Section 1 (a) and (b) of the bill. It is anticipated Section 1 (b)
would have to be authorized by federal law.
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*Fiscal Probable Savings/(Cost) from GR Probable Savings/(Cost) from *
* Year Match for Medicaid Federal Funds - Federal *
* 0758 0555 *
* 2002 $(1,293,218) $(1,648,228) *
* 2003 (2,276,659) (3,426,395) *
* 2004 (3,634,919) (5,468,309) *
* 2005 (4,991,203) (7,508,679) *
* 2006 (6,347,487) (9,549,049) *
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Technology Impact
Section 1 (b) of the bill would have a technology impact on the
Department of Human Services (DHS). Details are reflected below.
Fiscal Analysis
Section 1 (a) of the bill would direct the state Medicaid program to
provide medical assistance to aliens who entered the United States on or
after August 22, 1996, and who have resided in the United States for a
period of five years. This would increase the average number of Medicaid
recipients per month. Costs related to implementing this portion of the
bill are reflected in Scenario 1.
Section 1 (b) would direct the state Medicaid program to provide medical
assistance in the form of prenatal care, child delivery care, and
obstetrical care related to prenatal care and child delivery care to a
person who is pregnant and ineligible for medical assistance solely
because of having resided in the United states for less than five years.
It is anticipated Section 1 (b) would require a waiver from federal law.
Scenario 2 assumes such a waiver would be granted. Additional
programming changes within the automation system maintained by DHS would
be required under Scenario 2. Costs related to both sections of the bill
are reflected in Scenario 2.
Both scenarios assume an implementation date of January 2002. Fiscal
impacts have been adjusted accordingly.
Methodology
Scenario 1
1. An increase is assumed in the average monthly number of recipients
served by the Department of Health (TDH) totaling 491 in FY 2002, 1,620
in FY 2003, 2,586 in FY 2004, 3,551 in FY 2005, and 4,516 in FY 2006.
2. The average monthly cost for premiums and related services is assumed
to total $291.35 per client. This is the weighted average cost for all
client groups. No annual increase in costs is assumed. The federal
share of costs is assumed to be 60.2 percent in FY 2002, 60.08 percent in
FY 2003, and 60.07 percent in subsequent years.
Scenario 2: Assumes all costs under Scenario 1, plus the following:
1. It is assumed the following number of women would receive prenatal
care through a Medicaid waiver operated by TDH: 49 in FY 2002, 83 in FY
2003, 132 in FY 2004, 181 in FY 2005, and 229 in FY 2006. (It is assumed
these women would already be eligible for delivery services through the
Medicaid emergency care (cost-reimbursed) program.)
2. It is assumed that prenatal services would total $450 per women per
pregnancy. The federal share of costs is assumed to be 60.2 percent in FY
2002, 60.08 percent in FY 2003, and 60.07 percent in subsequent years.
3. DHS would implement changes in the automated eligibility system to
track newly eligible clients. It is estimated the effort would require
10,920 programming hours at a cost of $110 per hour, resulting in a one
time cost totaling $1,201,200. The federal share of costs is assumed
to be 50 percent.
Local Government Impact
No significant fiscal implication to units of local government is
anticipated.
Source Agencies: 529 Health and Human Services Commission, 324
Texas Department of Human Services, 501 Texas
Department of Health
LBB Staff: JK, HD, PP