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          A BILL TO BE ENTITLED
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          AN ACT
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        relating to a Medicaid buy-in program for employees of small  | 
      
      
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        businesses. | 
      
      
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               BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: | 
      
      
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               SECTION 1.  Subchapter B, Chapter 531, Government Code, is  | 
      
      
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        amended by adding Section 531.024442 to read as follows: | 
      
      
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               Sec. 531.024442.  MEDICAID BUY-IN PROGRAM FOR EMPLOYEES OF  | 
      
      
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        SMALL BUSINESSES.  (a)  In this section: | 
      
      
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                     (1)  "Program participant" means an employee of a small  | 
      
      
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        business who receives health care services under Medicaid through  | 
      
      
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        the buy-in program established under this section. | 
      
      
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                     (2)  "Small business" means a business with an annual  | 
      
      
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        gross revenue of $850,000 or less. | 
      
      
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               (b)  The commission shall operate a Medicaid buy-in program  | 
      
      
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        under which a person who is an employee of a small business may  | 
      
      
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        receive health care services under Medicaid. The executive  | 
      
      
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        commissioner shall adopt rules for the program that: | 
      
      
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                     (1)  establish eligibility requirements for  | 
      
      
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        participation in the program, including household income limits,  | 
      
      
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        that ensure receipt of federal matching money for providing health  | 
      
      
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        care services under Medicaid to a program participant; | 
      
      
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                     (2)  require financial participation by the program  | 
      
      
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        participant, including a requirement that the program participant  | 
      
      
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        pay, according to a sliding scale based on household income  | 
      
      
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        determined in accordance with commission rules, a portion of any  | 
      
      
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        premiums imposed or cost-sharing payments required under the  | 
      
      
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        program; and | 
      
      
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                     (3)  require financial participation by a small  | 
      
      
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        business that employs a program participant, including a  | 
      
      
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        requirement that the small business pay a portion of any premiums  | 
      
      
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        imposed or cost-sharing payments required under the program, in  | 
      
      
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        amounts determined in accordance with commission rules. | 
      
      
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               (c)  The executive commissioner shall ensure that the rules  | 
      
      
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        adopted under Subsection (b) regarding the financial participation  | 
      
      
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        required of a small business are not cost prohibitive to  | 
      
      
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        participation by a small business in the program. | 
      
      
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               (d)  The program under this section must be substantively  | 
      
      
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        identical to the Medicaid buy-in programs for persons with  | 
      
      
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        disabilities established under Section 531.02444, except to the  | 
      
      
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        extent that programmatic differences are appropriate because of the  | 
      
      
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        populations served by the programs. | 
      
      
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               (e)  The commission shall prepare and make available to small  | 
      
      
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        businesses information concerning the availability of and  | 
      
      
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        application process for the program under this section. A small  | 
      
      
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        business may provide that information to its employees and  | 
      
      
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        prospective employees.  | 
      
      
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               SECTION 2.  Not later than January 1, 2020, the executive  | 
      
      
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        commissioner of the Health and Human Services Commission shall  | 
      
      
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        adopt the rules required by Section 531.024442, Government Code, as  | 
      
      
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        added by this Act, and the commission shall implement the program  | 
      
      
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        required by that section. | 
      
      
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               SECTION 3.  If before implementing any provision of this Act  | 
      
      
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        a state agency determines that a waiver or authorization from a  | 
      
      
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        federal agency is necessary for implementation of that provision,  | 
      
      
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        the agency affected by the provision shall request the waiver or  | 
      
      
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        authorization and may delay implementing that provision until the  | 
      
      
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        waiver or authorization is granted. | 
      
      
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               SECTION 4.  This Act takes effect September 1, 2019. |