Honorable Lois W. Kolkhorst, Chair, Senate Committee on Health & Human Services
FROM:
Jerry McGinty, Director, Legislative Budget Board
IN RE:
SB989 by Huffman (relating to health benefit plan coverage for certain biomarker testing.), Committee Report 1st House, Substituted
Estimated Two-year Net Impact to General Revenue Related Funds for SB989, Committee Report 1st House, Substituted : a negative impact of ($2,687,068) through the biennium ending August 31, 2025.
The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill.
General Revenue-Related Funds, Five- Year Impact:
Fiscal Year
Probable Net Positive/(Negative) Impact to General Revenue Related Funds
2024
$0
2025
($2,687,068)
2026
($2,849,433)
2027
($2,976,211)
2028
($3,161,492)
All Funds, Five-Year Impact:
Fiscal Year
Probable (Cost) from GR Match For Medicaid 758
Probable (Cost) from Federal Funds 555
Probable Revenue Gain from General Revenue Fund 1
Probable Revenue Gain from Foundation School Fund 193
2024
$0
$0
$0
2025
($2,858,735)
($4,420,055)
$128,750
$42,917
2026
($2,984,257)
($4,607,930)
$101,118
$33,706
2027
($3,117,042)
($4,811,436)
$105,623
$35,208
2028
($3,258,156)
($5,027,310)
$72,498
$24,166
Fiscal Analysis
The bill would require affected health benefit plans, including the state Medicaid program and the Children's Health Insurance Program (CHIP), to provide coverage for biomarker testing for the diagnosis, treatment, management, monitoring of an enrollee's disease or condition when medically and scientifically supported.
Methodology
The bill would require HHSC to expand existing benefits for biomarker testing for Medicaid and CHIP clients. Assuming a September 1, 2024 start date, the additional average monthly Medicaid caseload associated with expanding biomarker testing covered benefits is estimated to be 7,501 in fiscal year 2025, increasing in each subsequent fiscal year to 7,774 in fiscal year 2028. The additional average monthly CHIP caseload is estimated to be 568 in fiscal year 2025, increasing in each subsequent fiscal year to 571 in fiscal year 2028. This results in an estimated cost of $7.3 million in All Funds, including $2.9 million in General Revenue, in fiscal year 2025, increasing each subsequent fiscal year to $8.3 million in All Funds, including $3.3 million in General Revenue in fiscal year 2028.
The net increases in client services payments through managed care are assumed to result in an increase to insurance premium tax revenue and vendor drug rebates. This results in assumed increased collections $0.2 million in fiscal year 2025, $0.1 million in fiscal year 2026, $0.1 million in fiscal year 2027, less than $0.1 million in fiscal year 2028. Pursuant to Section 227.001(b), Insurance Code, 25 percent of the revenue is assumed to be deposited to the credit of the Foundation School Fund.
Based on the analysis of the Employees Retirement System, Teacher Retirement System, Department of Insurance, Texas A&M University System Administrative & General Offices, and the University of Texas System Administration, duties and responsibilities associated with implementing the provisions of the bill could be accomplished by utilizing existing resources.
Local Government Impact
No significant fiscal implication to units of local government is anticipated.
Source Agencies:
323 Teacher Retirement System, 327 Employees Retirement System, 454 Department of Insurance, 529 Health and Human Services Commission, 710 Texas A&M University System Administrative and General Offices, 720 The University of Texas System Administration