H.B. 1118 78(R)    BILL ANALYSIS


H.B. 1118
By: Wohlgemuth
State Health Care Expenditures, Select
Committee Report (Unamended)



BACKGROUND AND PURPOSE 

Current Texas law does not satisfy the requirements necessary to obtain a
new federal waiver that will make it easier to offer premium assistance
under CHIP, which insures children who do not quality for Medicaid.  This
waiver would allow the state to provide assistance to a family whose
children qualify for CHIP but wish to enroll their children in their own
insurance.  HB 1118 amends the Health and Safety Code to meet those
requirements and enable the state to provide financial assistance to
parents who choose to enroll their CHIP-eligible children in their own
insurance programs. 

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to
a state officer, institution, or agency. 

ANALYSIS

SECTION 1.  Amends Section 62.059, Health and Safety code, as follow:

Sec. 62.059. New heading:  HEALTH INSURANCE PREMIUM ASSISTANCE PROGRAM FOR
CHILDREN ELIGIBLE FOR CHILD HEALTH PLAN. (a) Defines  
 "group health benefit plan."
  
  (b)  Requires the Health and Human Services Commission (HHSC), rather
than the 
  Texas Department of Health (TDH) under the direction of HHSC, to
identify children, 
  who are eligible to enroll in a group health benefit plan.

  (c)  Authorizes HHSC to determine cost-effective measures on an
aggregate basis for 
  the premium assistance program as a whole.  Makes a conforming change.

  (d)  Provides that if HHSC, rather than TDH, finds it cost-effective to
enroll the child  
  in the group health benefit plan, then HHSC, rather than TDH, is
required to: 
 
   1. Inform the child and the child's parent or guardian of the
availability of the 
   premium assistance program under this section, rather than require the 
   child to apply to enroll in the plan as condition for eligibility.  

   2.  Offer, as an optional alternative to enrollment in the commission's
state 
   child health benefit program, a premium assistance payment to assist
with 
   the employee's or member's share of the required premium for the group 
   health benefit plan that is available to the child; and

   3.  Provide certain written notice.  Subsection (d)(3) is created from
existing 
   text.


 (e) Requires HHSC to determine the amount of premium assistance payment,
rather than 
 TDH to provide for payment.  Requires the premium assistance payment to
be paid only 
 for the reimbursement of the employee's or member's share of required
premiums for 
  coverage of a child enrolled in the group health benefit plan. 

 (f)  Authorizes the premium assistance payment paid under Subsection (e)
to provide 
 assistance for the payment of a group health benefit plan premium that
includes the 
 child's parent or other individuals who are members of the child's
family.  Deletes existing 
 language regarding payment of premiums for family members of a child who
is not eligible 
 to enroll in the health group plan unless the other individual is
enrolled in the plan, if TDH 
 determines it to be cost-effective.  Makes conforming changes.

 (g)  Makes conforming changes.

 (h)  Deletes existing Subsection (h) regarding a child's enrollment in
the plan not affecting 
 the child's eligibility for benefits under this chapter.  Redesignates
Subsection (i) as 
 Subsection (h).  Makes conforming changes.

SECTION 2.  Amends Sections 2 (a),(b), and (f), Article 21.52K, Insurance
Code, to make conforming changes. 

SECTION 3.  

 (a)  Establishes an effective date of September 1, 2003. 
 
 (b)  Prospective clause.

EFFECTIVE DATE

This act takes effect September 1, 2003.