Bill Text: TX SB217 | 2021-2022 | 87th Legislature | Introduced


Bill Title: Relating to expanding eligibility for medical assistance to certain persons under the federal Patient Protection and Affordable Care Act and ensuring the provision of quality care under and the effectiveness of the medical assistance program.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2020-11-24 - Filed [SB217 Detail]

Download: Texas-2021-SB217-Introduced.html
  87R1295 MM-F
 
  By: West S.B. No. 217
 
 
 
A BILL TO BE ENTITLED
 
AN ACT
  relating to expanding eligibility for medical assistance to certain
  persons under the federal Patient Protection and Affordable Care
  Act and ensuring the provision of quality care under and the
  effectiveness of the medical assistance program.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Chapter 32, Human Resources Code, is amended by
  adding Subchapter H to read as follows:
  SUBCHAPTER H. EXPANSION OF ELIGIBILITY FOR MEDICAL ASSISTANCE
         Sec. 32.351.  DEFINITIONS. In this subchapter:
               (1)  "Medical assistance expansion group" means the
  category of persons who would not be eligible for medical
  assistance under the eligibility criteria in effect on December 31,
  2021, but who are eligible for that assistance because of the
  requirement of Section 32.352(a).
               (2)  "Undocumented immigrant" means a person who:
                     (A)  is not a citizen or other national of the
  United States; and
                     (B)  is not lawfully authorized to be present in
  the United States under the Immigration and Nationality Act (8
  U.S.C. Section 1101 et seq.) or other federal law.
         Sec. 32.352.  EXPANDED ELIGIBILITY FOR MEDICAL ASSISTANCE
  UNDER PATIENT PROTECTION AND AFFORDABLE CARE ACT. (a) 
  Notwithstanding any other law and except as provided in Subsection
  (b) and Section 32.353,  to the extent money is appropriated to the
  commission for that purpose, beginning January 1, 2022, the
  commission shall provide medical assistance to all persons who
  apply for that assistance and for whom federal matching money is
  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) to provide that
  assistance.
         (b)  Nothing in this section authorizes the commission to
  provide medical assistance to undocumented immigrants.
         (c)  The executive commissioner shall adopt rules regarding
  the provision of medical assistance as required by this section.
         Sec. 32.353.  RESTRICTED ELIGIBILITY FOR MEDICAL ASSISTANCE
  ON CHANGES IN FEDERAL MATCHING MONEY. (a) Notwithstanding any
  other law, if the federal medical assistance percentage (FMAP) by
  which this state's expenditures under the medical assistance
  program are matched with federal money, and that applies with
  respect to persons in the medical assistance expansion group, is
  less than the percentage provided for in 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), excluding subsequent amendments:
               (1)  the commission shall alert the Legislative Budget
  Board; and
               (2)  beginning on the first day of the month following
  the month in which the new federal medical assistance percentage
  (FMAP) becomes effective, the commission shall:
                     (A)  cease providing medical assistance to
  persons in the medical assistance expansion group; and
                     (B)  reinstate the eligibility criteria for
  medical assistance that existed on December 31, 2021.
         (b)  The executive commissioner shall adopt any rules
  necessary to implement any changes in the provision of and
  eligibility criteria for medical assistance required by this
  section.
         Sec. 32.354.  FEDERAL AUTHORIZATION FOR IMPLEMENTATION OF
  COST-SHARING OBLIGATIONS FOR MEDICAL ASSISTANCE EXPANSION GROUP.
  The executive commissioner shall seek a waiver or other appropriate
  authorization from the appropriate federal agency to develop and
  implement cost-sharing obligations for the medical assistance
  expansion group. Cost-sharing obligations developed by the
  commission under this section:
               (1)  must be designed to:
                     (A)  incentivize persons in the medical
  assistance expansion group to seek preventive or routine health
  care services, rather than emergency health care services, when
  possible and appropriate; and
                     (B)  guarantee quality health care for persons in
  the medical assistance expansion group;
               (2)  may include:
                     (A)  copayments and deductibles; and
                     (B)  modifications to the reimbursement
  methodologies for services provided to persons in the medical
  assistance expansion group; and
               (3)  may incorporate any other incentives or strategies
  that the commission determines are necessary, including:
                     (A)  expanded use of managed care;
                     (B)  increased reliance on private individual or
  employer-based health benefits coverage;
                     (C)  incentives and rewards for participation in
  evidence-based wellness activities; and
                     (D)  targeted benefits for chronic illnesses.
         Sec. 32.355.  ANNUAL REPORT ON EXPANDED ELIGIBILITY FOR
  MEDICAL ASSISTANCE. Not later than December 1 of each year, the
  commission shall report to the governor, the lieutenant governor,
  the speaker of the house of representatives, and the standing
  committees of the senate and the house of representatives having
  primary jurisdiction over the medical assistance program on the
  effects of expanding eligibility for medical assistance under
  Section 32.352, including the effects on:
               (1)  the number of persons in this state who do not have
  health benefits coverage;
               (2)  state health care costs, including costs relating
  to programs funded with money appropriated out of the general
  revenue fund;
               (3)  local health care costs; and
               (4)  charity care and uncompensated care costs for
  hospitals.
         SECTION 2.  Section 32.352, Human Resources Code, as added
  by this Act, applies only to an initial determination or
  recertification of eligibility of a person for medical assistance
  under Chapter 32, Human Resources Code, made on or after January 1,
  2022, regardless of the date the person applied for that
  assistance.
         SECTION 3.  As soon as possible after the effective date of
  this Act, the executive commissioner of the Health and Human
  Services Commission shall take all necessary actions to expand
  eligibility for medical assistance under Chapter 32, Human
  Resources Code, beginning January 1, 2022, and in accordance with
  Section 32.352, Human Resources Code, as added by this Act,
  including:
               (1)  notifying appropriate federal agencies of that
  expanded eligibility; and
               (2)  establishing work groups or consulting with
  stakeholder groups.
         SECTION 4.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 5.  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, 2021.
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