LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 77th Regular Session
  
                              March 28, 2001
  
  
          TO:  Honorable Patricia Gray, Chair, House Committee on Public
               Health
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  HB2420  by Coleman (Relating to the establishment of a
               pilot program to extend Medicaid coverage to certain
               low-income parents of children receiving Medicaid.), As
               Introduced
  
**************************************************************************
*  Estimated Two-year Net Impact to General Revenue Related Funds for    *
*  HB2420, As Introduced:  negative impact of $(114,051,772) 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.                                                             *
**************************************************************************
  
General Revenue-Related Funds, Five-Year Impact:
  
          ****************************************************
          *  Fiscal Year  Probable Net Positive/(Negative)   *
          *               Impact to General Revenue Related  *
          *                             Funds                *
          *       2002                        $(37,196,408)  *
          *       2003                         (76,855,364)  *
          *       2004                                    0  *
          *       2005                                    0  *
          *       2006                                    0  *
          ****************************************************
  
All Funds, Five-Year Impact:
  
***************************************************************************
*Fiscal     Probable (Cost) to Federal   Probable (Cost) to GR Match for  *
* Year           Funds - Federal                     Medicaid             *
*                      0555                            0758               *
*  2002                     $(56,261,904)                   $(37,196,408) *
*  2003                     (115,668,093)                    (76,855,364) *
*  2004                                 0                               0 *
*  2005                                 0                               0 *
*  2006                                 0                               0 *
***************************************************************************
  
Fiscal Analysis
  
The bill would require the Health and Human Services Commission (HHSC) to
develop and implement a pilot program extending Medicaid eligibility to
otherwise ineligible parents of children currently enrolled in Medicaid.


The bill would take effect September 1, 2001, and expire September 1,
2003.

The bill would require the HHSC to submit a report to the Legislature by
December 1, 2002, regarding the cost-effectiveness of the pilot project,
including recommendations regarding elimination, continuation, or
expansion of the pilot.
  
  
Methodology
  
It is assumed a federal waiver of current Medicaid regulations would be
needed in order to implement the pilot project.

The Texas Department of Health (TDH) assumes the pilot project would
cover three counties (McLennan, Hidalgo, and Cameron) and begin on March
1, 2002.

It is assumed the pilot project would serve 61,674 new Medicaid enrollees
in FY 2002, and 63,524 in FY 2003.  If the Legislature were to approve
the project to continue or expand beyond FY 2003, caseloads would be
assumed to increase by 3% each year and additional costs would result.

A monthly premium cost of $252.56 per enrollee is assumed.  This figure
includes Insured Services, Cost Reimbursed Services, Vendor Drug, and
Medical Transportation.

The Federal Medical Assistance Percentage (FMAP) is assumed to be 60.20%
for FY 2002, and 60.08% for FY 2003.

The Medicaid caseload increase during the pilot project could potentially
create the need for additional caseworkers and other administrative
costs associated with eligibility determination through the Department
of Human Services (DHS), but these costs have not been determined.
  
  
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, SW, PP