88R4375 MM-D
 
  By: Talarico H.B. No. 3267
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to establishing the Texas Care Plan Medicaid buy-in
  program to provide health benefit plan coverage to certain persons
  in this state.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter B, Chapter 531, Government Code, is
  amended by adding Section 531.024443 to read as follows:
         Sec. 531.024443.  TEXAS CARE PLAN MEDICAID BUY-IN PROGRAM.
  (a)  In this section, "program" means the Texas Care Plan Medicaid
  buy-in program implemented under this section.
         (b)  The commission shall seek a waiver under Section 1115 of
  the Social Security Act (42 U.S.C. Section 1315) to implement the
  Texas Care Plan Medicaid buy-in program in accordance with this
  section.
         (c)  The commission in consultation with the commissioner of
  insurance shall develop the program to allow residents of this
  state to purchase health benefit plan coverage through Medicaid by
  enrolling in a managed care plan offered by a Medicaid managed care
  organization.
         (d)  The executive commissioner shall adopt rules for the
  program that:
               (1)  establish eligibility requirements for
  participation, including:
                     (A)  household income limits;
                     (B)  a requirement that a program participant be
  ineligible for benefits under Medicaid, other than through the
  program; and
                     (C)  a requirement that a program participant not
  have health benefit coverage under another health benefit plan
  because the participant does not have access to or cannot afford
  coverage through an employer-sponsored health benefit plan; and
               (2)  require financial participation by a program
  participant, including a requirement that a program participant
  pay, according to a sliding scale based on household income
  determined in accordance with commission rules that are consistent
  with the cost-sharing reduction eligibility categories provided by
  45 C.F.R. Section 155.305(g), a portion of premiums imposed or
  cost-sharing payments required under the program.
         (e)  The program must be designed to leverage enhanced
  federal medical assistance percentage funding available under the
  Patient Protection and Affordable Care Act (Pub. L. No. 111-148) as
  amended by the Health Care and Education Reconciliation Act of 2010
  (Pub. L. No. 111-152).
         (f)  The program, including benefits offered under the
  program, must be substantively identical to the Medicaid buy-in
  programs established under Section 531.02444, except:
               (1)  to the extent that programmatic differences are
  appropriate because of the populations served by the programs; and
               (2)  that a health benefit plan under the program is not
  required to include nonemergency transportation services as
  defined by Section 531.02414.
         SECTION 2.  As soon as practicable after the effective date
  of this Act, the executive commissioner of the Health and Human
  Services Commission shall apply for and actively pursue the waiver
  from the Centers for Medicare and Medicaid Services or any other
  federal agency required by Section 531.024443(b), Government Code,
  as added by this Act. The commission may delay implementing Section
  531.024443, Government Code, as added by this Act, until the waiver
  applied for under this section is granted.
         SECTION 3.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution.  If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2023.