| TO: | Honorable David Dewhurst, Lieutenant Governor, Senate |
| FROM: | John S. O'Brien, Deputy Director, Legislative Budget Board |
| IN RE: | SB747 by Carona (Relating to establishing a demonstration project for women's health care services. ), As Passed 2nd House |
| Fiscal Year | Probable Net Positive/(Negative) Impact to General Revenue Related Funds |
|---|---|
| 2006 | ($2,819,105) |
| 2007 | $23,138,100 |
| 2008 | $23,513,205 |
| 2009 | $23,886,239 |
| 2010 | $24,281,250 |
| Fiscal Year | Probable (Cost) from GR MATCH FOR MEDICAID 758 |
Probable Savings from GR MATCH FOR MEDICAID 758 |
Probable (Cost) from FEDERAL FUNDS 555 |
Probable Savings from FEDERAL FUNDS 555 |
|---|---|---|---|---|
| 2006 | ($2,819,105) | $0 | ($13,737,804) | $0 |
| 2007 | ($2,604,908) | $25,743,008 | ($13,675,769) | $39,379,704 |
| 2008 | ($2,645,649) | $26,158,854 | ($13,889,657) | $39,982,370 |
| 2009 | ($2,687,622) | $26,573,861 | ($14,110,015) | $40,616,686 |
| 2010 | ($2,732,068) | $27,013,318 | ($14,343,355) | $41,288,371 |
The bill would require the Health and Human Services Commission (HHSC) to develop a five-year demonstration project in the state Medical Assistance (Medicaid) program relating to preventive health and family planning.
The bill would require HHSC to establish a five-year demonstration project through the medical assistance program to expand access to preventive health and family planning services for women. Women eligible under Subsection (b) to participate in the demonstration project may receive appropriate preventive health and family planning services, including: medical history recording and evaluation; physical exams; health screenings, including diabetes and certain cancers; counseling and education on contraceptive methods, except regarding emergency contraception; provision of contraceptives, except for emergency contraceptives; risk assessment; and referral of medical problems. The bill would prohibit the referral of patients to providers who perform elective abortions or that are affiliated with entities that perform elective abortions.
The bill would state that a woman is eligible to participate in the project if she is at least 18 years old; has a net family income at or below 185% FPL; participates in or receives benefits under HHS programs, i.e, Medicaid, Food Stamps, TANF, and WIC; is presumed eligible for one of the above programs; or is a member of a family that contains at least one person who participates in or receives benefits under one of these programs.
The bill would require the department to submit a report to the legislature regarding the progress in establishing and operating the project, no later than December 1 of each even-numbered year.
The bill would require that the department ensure that money spent under the project is not used for abortions or to contract with providers who perform abortions, or providers affiliated with entities that perform abortions.
The effective date is September 1, 2005.
HHSC states the waiver application process would take roughly six months, so the project would begin February 1, 2006. HHSC assumes that the requirement prohibiting contracts with abortion providers would limit the eligible provider base and therefore, the number of women who could be served in the waiver.
Cost for family planning services: HHSC's cost estimate assumes that 2 million women per year would be eligible for the waiver and that 1/3 would enter the waiver. The population is further adjusted for a fertility rate of 8 percent and utilization of services of 50 percent. The potential clients are adjusted by 37 percent for the assumed decreased access due to limitation of the eligible provider base. A blended matching rate of 84 percent federal/16 percent state is assumed for services.
Savings from averted Medicaid costs: HHSC's analysis states that the above cost is offset by the savings that result from the averted cost of Medicaid-funded births. Due to the time needed to develop and approve a waiver and to account for gestational time for savings due to an averted birth, no averted births are assumed in FY 2006. Delivery and newborn costs averted are assumed to average $8,448 per year. Medicaid services receive a 60% federal match.
| Source Agencies: | 529 Health and Human Services Commission, 537 Department of State Health Services
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| LBB Staff: | JOB, SD, CL, PP, MB, KF
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