LEGISLATIVE BUDGET BOARD
                              Austin, Texas
                                     
                    FISCAL NOTE, 77th Regular Session
  
                              March 22, 2001
  
  
          TO:  Honorable Toby Goodman, Chair, House Committee on
               Juvenile Justice & Family Issues
  
        FROM:  John Keel, Director, Legislative Budget Board
  
       IN RE:  SB236  by Harris (relating to court-ordered medical
               support for certain children.), Committee Report 2nd
               House, Substituted
  
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*  No significant fiscal implication to the State is anticipated.        *
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The bill would provide for  court ordered medical support of a minor
child, including ordering a custodial parent to apply for public-funded
health insurance such as the Children's Health Insurance Program (CHIP).
The bill would provide for temporary order and consideration of the
reasonableness of the cost of insurance. The Health and Human Services
Commission's caseload projections are based upon the total number of
uninsured children in the state; thus, uninsured children in the IV-D
caseload or private child support cases are included within these
projections. Further, the number of uninsured children who eventually
enroll in Medicaid or CHIP will be limited by (1) the availability of
private insurance through the non-custodial or custodial parent, (2)
crowd-out provisions in existing law, and (3) failure to meet other
eligibility requirements such as income.  The cost of providing health
insurance coverage to any child whose enrollment in CHIP or Medicaid is
facilitated by SB 236 is as follows:  for 2001, average HMO premium cost
per child in CHIP is $80.86 per month, and average premium cost for TANF
child in Medicaid is $88.49. (The cost per child in the Medicaid program
varies considerably depending on the group of children being served.)
Costs in CHIP are offset by premium cost-sharing.
  
Local Government Impact
  
No fiscal implication to units of local government is anticipated.
  
  
Source Agencies:   529   Health and Human Services Commission
LBB Staff:         JK, JC, TB, AJ