SRC-MSY, TAG S.B. 240 78(R)   BILL ANALYSIS


Senate Research Center   S.B. 240
By: Averitt
State Affairs
3/3/2003
As Filed



DIGEST 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, a program that provides insurance to children who do not
qualify for Medicaid.  The waiver allows the state to provide assistance
to a family whose children qualify for CHIP but wish to enroll their
children in their own insurance. As proposed, S.B. 240 amends the Health
and Safety Code to meet those requirements and thereby enable the state to
provide financial assistance to those 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. 

SECTION BY SECTION ANALYSIS

SECTION 1.  Amends Section 62.059, Health and Safety Code, as follows:

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 its cost-effective to
enroll the child in the group health benefit plan, then HHSC, rather than
the 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 plan 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.  Effective date: September 1, 2003.
            Makes application of this Act prospective.