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A BILL TO BE ENTITLED
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AN ACT
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relating to establishing a program designed to ensure health |
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benefit plan coverage to certain children 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. PROGRAM TO ENSURE HEALTH BENEFIT PLAN COVERAGE FOR |
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CERTAIN CHILDREN THROUGH PRIVATE MARKET SOLUTIONS |
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Sec. 540.0001. PROGRAM FOR HEALTH BENEFIT PLAN COVERAGE FOR |
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CHILDREN THROUGH PRIVATE MARKET SOLUTIONS. The commission in |
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consultation with the commissioner of insurance shall develop and |
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implement a program that helps connect certain children in this |
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state with health benefit plan coverage through private market |
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solutions. |
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Sec. 540.0002. ENROLLMENT ELIGIBILITY. (a) Subject to |
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Subsection (b), a child is eligible to enroll in a program designed |
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and established under this chapter if the child: |
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(1) is younger than 19 years of age; |
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(2) is not eligible for benefits under Medicaid or the |
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child health plan program because of applicable income limits; and |
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(3) does not have health benefit coverage under a |
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health benefit plan because the child's family does not have access |
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to or cannot afford a plan through the private marketplace, |
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including: |
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(A) an employer-sponsored health benefit plan; |
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or |
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(B) a health benefit plan for which an enrollee |
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receives a premium subsidy under the Patient Protection and |
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Affordable Care Act (Pub. L. No. 111-148) due to the amount of |
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family income. |
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(b) The executive commissioner shall further define the |
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program's eligibility requirements, including defining income |
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requirements necessary to enroll in the program. |
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Sec. 540.0003. MINIMUM PROGRAM REQUIREMENTS. A program |
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designed and established under this chapter must: |
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(1) provide premium assistance to purchase health |
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benefit plan coverage for a child in the private market; and |
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(2) use technology to maximize the efficiency with |
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which the commission and any health benefit plan issuer manages |
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enrollee participation. |
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Sec. 540.0004. RULES. The executive commissioner may adopt |
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rules necessary to implement this chapter. |
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SECTION 2. As soon as practicable after the effective date |
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of this Act, the executive commissioner of the Health and Human |
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Services Commission shall develop and implement the program |
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required by Chapter 540, Government Code, as added by this Act. |
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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, 2021. |