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A BILL TO BE ENTITLED
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AN ACT
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relating to seeking federal authorization to provide health benefit |
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plan coverage to certain low-income individuals through the private |
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marketplace. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Subtitle I, Title 4, Government Code, is amended |
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by adding Chapter 540 to read as follows: |
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CHAPTER 540. FEDERAL WAIVER FOR HEALTH BENEFIT PLAN COVERAGE |
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THROUGH PRIVATE MARKETPLACE |
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Sec. 540.001. DEFINITIONS. In this chapter: |
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(1) "Expansion population" means residents of this |
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state: |
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(A) who were not eligible to receive benefits |
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under the eligibility criteria for the Medicaid program in effect |
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on December 31, 2013; and |
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(B) for whom federal matching funds are available |
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under the Patient Protection and Affordable Care Act (Pub. L. |
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No. 111-148) as amended by the Health Care and Education |
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Reconciliation Act of 2010 (Pub. L. No. 111-152) to provide |
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Medicaid benefits. |
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(2) "Medicaid program" means the medical assistance |
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program established under Title XIX, Social Security Act (42 U.S.C. |
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Section 1396 et seq.). |
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Sec. 540.002. FEDERAL AUTHORIZATION FOR HEALTH BENEFIT PLAN |
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COVERAGE THROUGH PRIVATE MARKETPLACE. (a) Notwithstanding any |
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other law, the executive commissioner shall seek a waiver under |
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Section 1115 of the Social Security Act (42 U.S.C. Section 1396 et |
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seq.) to the state Medicaid plan to develop and implement a program |
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to assist the expansion population with obtaining health benefit |
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plan coverage through the private marketplace. The terms of a |
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waiver under this section must: |
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(1) provide for the implementation of sliding scale |
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subsidies: |
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(A) based on an individual's ability to pay; and |
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(B) designed to assist eligible individuals with |
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purchasing a health benefit plan from credible health benefit plan |
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issuers; |
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(2) require the implementation of health savings |
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accounts and point-of-service cost-sharing by individuals meant to |
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encourage the appropriate use of health care benefits and wellness; |
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(3) include personal responsibility requirements for |
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individuals enrolled in the program, including incentives for |
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seeking and maintaining employment; |
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(4) impose financial penalties on individuals |
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enrolled in the program for inappropriate use of hospital emergency |
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room services for non-emergent care; |
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(5) provide for implementation of a small-employer |
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subsidy designed to encourage those employers to provide health |
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benefit coverage options as a benefit to employees who are members |
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of the expansion population; and |
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(6) be designed to establish a transparent process for |
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determining the cost savings realized under the waiver by local |
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governments and local property taxpayers that result from reduced |
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costs associated with providing indigent care services. |
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(b) The executive commissioner shall adopt rules necessary |
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to implement this section. |
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SECTION 2. Not later than December 1, 2015, the executive |
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commissioner of the Health and Human Services Commission shall |
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adopt rules necessary to implement Section 540.002, Government |
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Code, as added by this Act. |
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SECTION 3. This Act takes effect immediately if it receives |
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a vote of two-thirds of all the members elected to each house, as |
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provided by Section 39, Article III, Texas Constitution. If this |
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Act does not receive the vote necessary for immediate effect, this |
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Act takes effect September 1, 2015. |