By: Coleman H.B. No. 2224
 
 
A BILL TO BE ENTITLED
AN ACT
relating to eligibility for and the administration of the child
health plan program; making an appropriation.
       BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
ARTICLE 1. LEGISLATIVE FINDINGS; APPROPRIATION
       SECTION 1.01.  FINDINGS. The legislature finds that:
             (1)  the drastic reductions in funding for the
children's health insurance programs and the extensive public
policy changes made to the program in the regular session of the
78th Legislature have resulted in devastating effects to the health
and well-being of Texas children and their families and to the
overall fiscal health of this state;
             (2)  economic research has proven that reductions in
state funding for health care services do more harm than good to the
Texas economy because each dollar of state revenue that is
eliminated from the children's health insurance programs results
in:
                   (A)  an average loss of $2.30 in federal health
care funding for Texas and an average loss of approximately $7 in
gross state product, $5 in personal income, and $2 in retail sales;
and
                   (B)  an increase of $1.60 in the insurance
premiums for Texans who have private health insurance, plus a $1.50
increase in those Texans' out-of-pocket health care costs;
             (3)  as a result of these shortsighted and
counterproductive reductions in health care services made by the
78th Legislature, local taxpayers bear the entire cost of health
care for persons who are no longer receiving services under the
children's health insurance program, often through vastly more
expensive visits to hospital emergency rooms, even though the
federal government would have paid about 70 percent of the cost of
those services through the program;
             (4)  children in other states have already received
over $913.4 million in federal funds that were intended to provide
health care coverage for Texas children under the children's health
insurance program, which includes $20 million in federal funds
scheduled to lapse on March 31, 2007, and this state will lose
additional federal funds each year if the state fails to restore
state funding and repeal the restrictive eligibility and benefits
policies enacted by the 78th Legislature;
             (5)  restoring benefits under the children's health
insurance program and expanding that program to cover more
uninsured children will result in healthier future generations of
Texans and immeasurable long-term savings for this state;
             (6)  this state must make its economy stronger and its
workforce more productive by improving access to health care
through prudent and sound fiscal policies that maximize the
availability of federal funds for health care services for
uninsured Texans; and
             (7)  the investment of state resources to maximize
receipt of federal funds as described by Subdivision (6) of this
section will:
                   (A)  prevent the redistribution to other states of
tax dollars that Texans have paid to the federal government;
                   (B)  alleviate the inefficient cost-shifting of
health care services for uninsured Texans to local governments; and
                   (C)  stem the escalation of costs being passed on
to Texans who have private health insurance.
       SECTION 1.02.  PURPOSE. As a result of the findings made by
the legislature as stated in Section 1.01 of this article, the
purposes of this Act are to:
             (1)  restore funding for the children's health
insurance program that was reduced by the 78th Legislature;
             (2)  reverse restrictive policy changes made by that
legislature with respect to the program; and
             (3)  expand enrollment in the program beyond the
enrollment levels that existed before September 1, 2003.
ARTICLE 2. RESTORATION AND EXPANSION OF THE CHILDREN'S HEALTH
INSURANCE PROGRAM
       SECTION 2.01.  Section 62.002(4), Health and Safety Code, is
amended to read as follows:
             (4)  "Net [Gross] family income" means the [total]
amount of income established for a family after reduction for
offsets for expenses such as child care and work-related expenses,
in accordance with standards applicable under the Medicaid [without
consideration of any reduction for offsets that may be available to
the family under any other] program.
       SECTION 2.02.  Subchapter B, Chapter 62, Health and Safety
Code, is amended by adding Sections 62.056, 62.057, 62.060, and
62.061 to read as follows:
       Sec. 62.056.  COMMUNITY OUTREACH CAMPAIGN; TOLL-FREE
HOTLINE.  (a)  The commission shall conduct a community outreach and
education campaign to provide information relating to the
availability of health benefits for children under this chapter.
The commission shall conduct the campaign in a manner that promotes
enrollment in, and minimizes duplication of effort among, all
state-administered child health programs.
       (b)  The community outreach campaign must include:
             (1)  outreach efforts that involve school-based health
clinics; and
             (2)  a toll-free telephone number through which
families may obtain information about health benefits coverage for
children.
       (c)  The commission shall contract with community-based
organizations or coalitions of community-based organizations to
implement the community outreach campaign and shall also promote
and encourage voluntary efforts to implement the community outreach
campaign. The commission shall procure the contracts through a
process designed by the commission to encourage broad participation
of organizations, including organizations that target population
groups with high levels of uninsured children.
       Sec. 62.057.  REGIONAL ADVISORY COMMITTEES.  (a)  The
commission shall appoint regional advisory committees to provide
recommendations on the operation of the child health plan program.
       (b)  The advisory committees, to the extent possible, must be
composed of representatives of:
             (1)  hospitals;
             (2)  insurance companies and health maintenance
organizations eligible to offer the health benefits coverage under
the child health plan;
             (3)  primary care providers;
             (4)  consumer advocates, including advocates for
children with special health care needs;
             (5)  parents of children who are enrolled in the child
health plan;
             (6)  rural health care providers;
             (7)  specialty health care providers, including
pediatric providers;
             (8)  community-based organizations that provide
community outreach under Section 62.056; and
             (9)  state agencies.
       (c)  The commission shall establish the regional advisory
committees, consistent with Subsection (b), in regions of this
state in a manner that ensures geographic representation.
       (d)  In implementing this section, the commission may use
other regional advisory structures, augmented to ensure the
representation required by Subsection (b), to the extent necessary
to avoid duplication of administrative activities.
       (e)  The advisory committees shall meet at least quarterly
and are subject to Chapter 551, Government Code.
       (f)  Section 2110.008, Government Code, does not apply to the
advisory committees.
       Sec. 62.060.  AMOUNT OF STATE CONTRIBUTION.  (a)  Not later
than November 1 preceding each regular session of the legislature,
the executive commissioner of the commission shall certify to the
Legislative Budget Board the amount necessary to draw down the
maximum amount of federal money available for the child health plan
during the following state fiscal biennium, including any federal
money unused from a previous biennium that is available for that
biennium.
       (b)  Each legislative session the legislature shall
appropriate to the commission for the purpose of providing services
under the child health plan the amount certified under Subsection
(a).
       Sec. 62.061.  EXPENDITURE OF AVAILABLE MONEY. For each state
fiscal biennium the commission shall develop a plan to use all
federal money available for the state child health plan for that
biennium, including money remaining from previous years'
allocations of federal money for the plan, by maximizing the number
of children provided services under the plan.
       SECTION 2.03.  Section 62.101(b), Health and Safety Code, is
amended to read as follows:
       (b)  The commission shall establish income eligibility
levels consistent with Title XXI, Social Security Act (42 U.S.C.
Section 1397aa et seq.), as amended, and any other applicable law or
regulations, and subject to the availability of appropriated money,
so that a child who is younger than 19 years of age and whose net
[gross] family income is at or below 200 percent of the federal
poverty level is eligible for health benefits coverage under the
program. [In addition, the commission may establish eligibility
standards regarding the amount and types of allowable assets for a
family whose gross family income is above 150 percent of the federal
poverty level.]
       SECTION 2.04.  Section 62.102, Health and Safety Code, is
amended to read as follows:
       Sec. 62.102.  CONTINUOUS COVERAGE. The commission shall
provide that an individual who is determined to be eligible for
coverage under the child health plan remains eligible for those
benefits until the earlier of:
             (1)  the end of a period, not to exceed 12 months, [the
six month period] following the date of the eligibility
determination; or
             (2)  the individual's 19th birthday.
       SECTION 2.05.  Section 62.151(b), Health and Safety Code, is
amended to read as follows:
       (b)  In developing the covered benefits, the commission
shall consider the health care needs of healthy children and
children with special health care needs. The child health plan must
provide at least the covered benefits described by the recommended
benefits package described for a state-designed child health plan
by the Texas House of Representatives Committee on Public Health
"CHIP" Interim Report to the Seventy-Sixth Texas Legislature dated
December 1998 and the Senate Interim Committee on Children's Health
Insurance Report to the Seventy-Sixth Texas Legislature dated
December 1, 1998. The child health plan must include at least the
covered benefits provided under the plan on June 1, 2003.
       SECTION 2.06.  Sections 62.154(a) and (d), Health and Safety
Code, are amended to read as follows:
       (a)  To the extent permitted under Title XXI of the Social
Security Act (42 U.S.C. Section 1397aa et seq.), as amended, and any
other applicable law or regulations, the child health plan must
include a waiting period and[. The child health plan] may include
copayments and other provisions intended to discourage:
             (1)  employers and other persons from electing to
discontinue offering coverage for children under employee or other
group health benefit plans; and
             (2)  individuals with access to adequate health benefit
plan coverage, other than coverage under the child health plan,
from electing not to obtain or to discontinue that coverage for a
child.
       (d)  The waiting period required by Subsection (a) must:
             (1)  extend for a period of 90 days after[:
             [(1)]  the last date on [first day of the month in]
which the applicant was covered under a health benefits plan; and
             (2)  apply to a child who was covered by a health
benefits plan at any time during the 90 days before the date of
application for coverage under the child health plan [is enrolled
under the child health plan, if the date of enrollment is on or
before the 15th day of the month; or
             [(2)  the first day of the month after which the
applicant is enrolled under the child health plan, if the date of
enrollment is after the 15th day of the month].
       SECTION 2.07.  The following laws are repealed:
             (1)  Section 62.151(f), Health and Safety Code; and
             (2)  Section 62.153(d), Health and Safety Code.
ARTICLE 3. COMPLIANCE WITH FEDERAL REQUIREMENTS; EFFECTIVE DATE
       SECTION 3.01.  FEDERAL WAIVER AS PREREQUISITE TO
IMPLEMENTATION. 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 agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
       SECTION 3.02.  EFFECTIVE DATE. Except as otherwise provided
by this Act, this Act takes effect September 1, 2007.