78R7952 CLG-D

By:  Coleman                                                      H.B. No. 2604



A BILL TO BE ENTITLED

AN ACT

relating to health benefits coverage for certain low-income parents 
of children receiving Medicaid or enrolled in the state child 
health plan.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  Subchapter B, Chapter 531, Government Code, is 
amended by adding Section 531.02192 to read as follows:
	Sec. 531.02192.  HEALTH BENEFITS COVERAGE FOR CERTAIN 
LOW-INCOME PARENTS.  (a)  The commission shall develop and 
implement a statewide program in which health benefits coverage is 
provided to an individual who:
		(1)  is the parent of a child receiving medical 
assistance under the state Medicaid program or of a child enrolled 
in the state child health plan program under Chapter 62, Health and 
Safety Code;
		(2)  has a family income that is at or below 200 percent 
of the federal poverty level; and
		(3)  is not covered by health insurance or another type 
of health benefit plan other than a health benefit plan that is 
administered by or on behalf of a local governmental entity.
	(b)  The commission shall ensure that the program is designed 
and administered in a manner that qualifies for federal funding and 
is financed using state money and money made available by local 
governmental entities to the commission for federal matching 
purposes.  Local money described by this subsection includes tax or 
other revenue spent to provide indigent health care services to 
eligible individuals before they were eligible to receive health 
benefits coverage under this section and any other resources made 
available to the commission under this section for federal matching 
purposes.
	(c)  In establishing the program, the commission shall:                 
		(1)  develop a health benefit plan to provide coverage 
for health care services to eligible individuals that:
			(A)  requires plan coverage to be purchased using 
a combination of local, federal, and state contributions;
			(B)  provides a benefits package that is similar 
to the state child health plan program benefits; and
			(C)  to the extent possible eliminates coverage 
for duplicative or extraordinary services; and
		(2)  not later than the 180th day before the date on 
which the commission plans to begin to provide health coverage to 
recipients through the program, appoint an advisory committee to 
provide recommendations on the implementation and operation of the 
program, including the development of the health benefit plan.
	(d)  The advisory committee described by Subsection (c)(2) 
must be composed of representatives of:
		(1)  local governmental entities that make funds 
available to the commission in accordance with this section;
		(2)  insurance companies and health maintenance 
organizations eligible to offer health benefits coverage under the 
health benefit plan; and
		(3)  consumer advocates.                                               
	(e)  In developing the health benefit plan under Subsection 
(c)(1), the commission must include provisions intended to 
discourage:
		(1)  employers and other persons from electing to 
discontinue offering coverage for individuals under employee or 
other group health benefit plans; and
		(2)  individuals with access to adequate health benefit 
plan coverage, other than coverage under the health benefit plan 
developed under Subsection (c)(1), from electing not to obtain or 
to discontinue that coverage.
	(f)  At the request of the commission, the Texas Department 
of Insurance shall provide any necessary assistance with the 
development of the health benefit plan under Subsection (c)(1).
	(g)  The commission shall:                                              
		(1)  adopt an application form and application 
procedures for requesting health benefit plan coverage under this 
section;
		(2)  develop eligibility determination and enrollment 
procedures for the program; and
		(3)  select the health benefit plan providers under the 
program through a competitive procurement process.
	(h)  The commission shall adopt rules as necessary to 
implement this section.
	SECTION 2.  Not later  than September 1, 2003, the Health and 
Human Services Commission shall request and actively pursue any 
necessary waivers from a federal agency or any other appropriate 
entity to enable the commission to implement the program 
established under Section 531.02192, Government Code, as added by 
this Act.  The commission may delay implementing the program 
described by that section until the necessary waivers or 
authorizations are granted.
	SECTION 3.  The Health and Human Services Commission is not 
required to implement Section 531.02192, Government Code, as added 
by this Act, unless a specific appropriation for the implementation 
is provided in the General Appropriations Act, Acts of the 78th 
Legislature, Regular Session, 2003.
	SECTION 4.  This Act takes effect September 1, 2003.