Amend CSSB 1 (house committee printing) in Article II of the bill, following the appropriations to the Health and Human Services Commission (page II-35), as follows:

(1)  On page II-95 of the Health and Human Services Commission bill pattern, strike Rider 184.

(2)  On page II-96 of the Health and Human Services Commission bill pattern, strike Rider 186 and substitute the following text:

Federal Flexibility. Included in amounts appropriated above in Goal A, Medicaid Client Services, is a reduction of $1,000,000,000 in general revenue funds and $1,368,000,000 in federal funds for the 2018-19 biennium. The Health and Human Services Commission (HHSC) shall pursue flexibility from the federal government to reduce the cost of providing Medicaid services to achieve the assumed level of savings without changing eligibility levels; reducing benefits; adjusting amount, scope, or duration of services; or otherwise negatively impacting access to care. Prior to making any changes, HHSC shall consider stakeholder input, including complying with any statutory requirements related to rulemaking and public hearings. HHSC shall determine the cost savings, as well as any impact to populations served, associated with any flexibility achieved and notify the Legislative Budget Board of any changes implemented in the Medicaid or Children's Health Insurance Programs.