H.B. 3484 78(R)    BILL ANALYSIS


H.B. 3484
By: Delisi
State Health Care Expenditures, Select
Committee Report (Unamended)



BACKGROUND AND PURPOSE 

Currently, there is no provision in state law for a Medicaid buy-in
program.  People with disabilities might be forced to choose between
keeping needed health care coverage and giving it up in order to be
employed.  A work group can document the types of benefits employees with
disabilities need, typical employer benefits offered, Medicaid benefits
needed and the ability of workers with disabilities to pay a portion of
health care premiums.  As proposed, H.B. 3484 sets up a work group on
health care options for certain persons with disabilities to study
creating a Medicaid buy-in program in Texas.  There is a Federal program
which makes funds available for such a study without any state match
required. 

RULEMAKING AUTHORITY

It is the committee's opinion that this bill does not expressly grant any
additional rulemaking authority to a state officer, department, agency, or
institution. 

ANALYSIS

SECTION 1.  Amends Chapter 531B, Government Code, by adding Section
531.02443, as follows: 

Sec. 531.02443.  WORK GROUP ON HEALTH CARE OPTIONS FOR CERTAIN PERSONS
WITH DISABILITIES.  (a)  Provides that a work group is established to
assist the Health and Human Services Commission (HHSC) in identifying,
recommending, and developing policy options to improve access to health
care coverage and services necessary to support increased employment of
persons with disabilities in this state. 

(b)  Requires HHSC to determine the number of members of the work group.
Provides that the work group is composed of representatives from certain
state agencies and certain other persons.  

(c)  Requires the commissioner of health and human services (commissioner)
to designate a member of the  work group to serve as presiding officer.
Requires the members of the work group to elect any other necessary
officers. 

(d)  Requires the work group to meet at the call of the commissioner.

(e)  Provides that a member of the work group serves at the will of the
appointing official or entity. 
 
(f)  Prohibits a member of the work group from receiving compensation for
serving on the  work group but provides that the member is entitled to
reimbursement for travel expenses incurred by the member while conducting
the business of the work group as provided by the General Appropriations
Act. 
 
(g)  Requires the work group to examine options for access to health care
coverage and services for employed persons with disabilities in this
state.  Requires the work group, in examining those options, to make
certain determinations.  

(h)  Requires the work group, based on the determinations under Subsection
(g), to  develop a proposal for a Medicaid buy-in program for this state,
including eligibility and premium  or other cost-sharing policies. 

(i)  Requires the work group to report its determinations under Subsection
(g) and the proposal required by Subsection (h) to HHSC.  Requires HHSC,
with the assistance of the work group, to compile the information and
prepare a report regarding  policy options to improve access to health
care coverage and services necessary to support increased employment of
persons with disabilities in this state.  Requires HHSC by November 1,
2004 to submit the report to the legislature. 

  (j)  Provides that this section expires September 1, 2005.

SECTION 2.  Requires HHSC to use the federal grant awarded to HHSC in 2001
under the Ticket to Work and Work Incentives Improvement Act of 1999 (Pub.
L. No. 106-170), as amended, to support the design, establishment, and
operation of infrastructures in this state that provide support services
for employed persons with disabilities.  Requires HHSC to actively pursue
the award of additional grants under that Act. 

EFFECTIVE DATE

This Act takes effect immediately if it receives a vote of two-thirds of
all the members of each house, as provided by Section 39, Article III,
Texas Constitution.  If the Act does not receive the necessary vote for
immediate effect, this Act takes effect September 1, 2003.