BILL ANALYSIS
By: Lucio III
Committee Report (Substituted)
BACKGROUND AND PURPOSE
In Texas, families with an income level high enough to make them ineligible for Medicaid often cannot afford paying for the full medical care of a child with a disability. Often times these families are forced to take extreme measures such as taking a lower paying job in order to make them eligible for Medicaid. Under current law, Medicaid eligibility does not take into account a child's disability. C.S.H.B. 1738 would allow families with disabled children to participate in a Medicaid assistance buy-in program.
RULEMAKING AUTHORITY
It is the committee's opinion that rulemaking authority is expressly granted to the executive commissioner of the Health and Human Services Commission in SECTION 1 of this bill.
ANALYSIS
C.S.H.B. 1738 would allow families with disabled children to participate in a Medicaid assistance buy-in program. The substitute requires the executive commissioner of the Health and Human Services Commission (HHSC) to develop an implement a Medicaid buy-in program, as authorized by the Deficit Reduction Act of 2005, for children with Down syndrome or another disability and whose family incomes do not exceed 300 percent of the applicable federal poverty level. The substitute requires the executive commissioner of the HHSC to adopt rules in accordance with federal law that provide eligibility requirements for the program and requirements for participants in the program to pay premiums or cost-sharing payments. The substitute provides that the rules adopted by the executive commissioner of the HHSC must require a participant to pay monthly premiums according to a sliding scale that is based on family income, subject to requirements of 42 U.S.C. Sections 1396o (i) (2) and (3).
If before implementing any provision of this Act a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the state agency affected by the provision is required to request the waiver or authorization and is authorized to delay implementing that provision until the waiver or authorization is granted.
EFFECTIVE DATE
September 1, 2007.
COMPARISON OF ORIGINAL TO SUBSTITUTE
The introduced version of HB 1738 provided Medicaid coverage to all children diagnosed with Down syndrome and not otherwise eligible for medical assistance due to income or resource eligibility criteria. The substitute differs from the original by requiring the executive commissioner of the Health and Human Services Commission to develop and implement a Medicaid buy-in program for children with Down syndrome or another disability. The substitute sets eligibility for the program to families whose income dose not exceed 300 percent of the applicable federal poverty level.