HB 838

84(R) - 2015
House Insurance
House Insurance

Vote Recommendation

  • Negative
  • Neutral
  • Neutral
  • Negative
  • Neutral


Elliot Naishtat

Bill Caption

Relating to the definition of serious mental illness for purposes of certain group health benefit plans.

Fiscal Notes

No significant fiscal implication to the State is anticipated.

Based on information provided by the Texas Department of Insurance (TDI), the bill could result in a slight increase of form filing revenues deposited to the General Revenue-Dedicated Texas Department of Insurance Fund 36 (GR-D Fund 36).  Since GR-D Fund 36 is a self-leveling account, this analysis also assumes that any additional revenue resulting from the implementation of the bill would accumulate in account fund balances and that TDI would adjust the assessment of the maintenance tax or other fees accordingly in the following year.  Additionally, this analysis assumes that all duties and responsibilities necessary to implement the provisions of the bill could be accomplished within existing staff and resources.

No fiscal implication to units of local government is anticipated.

Bill Analysis

As described by Section 1355.004 of the Insurance Code, current law requires a group health benefit plan to provide coverage, based on medical necessity, for not less than the following treatments of serious mental illness in each calendar year:

  1. 45 days of inpatient treatment; and
  2. 60 visits for outpatient treatment, including group and individual outpatient treatment.

Section 1355.007 also currently states an issuer of a group health benefit plan to a small employer must offer the coverage described by Section 1355.004 to the employer but is not required to provide the coverage if the employer rejects the coverage.

This bill would amend Chapter 1355 of the Insurance Code by incorporating post-traumatic stress disorder (PTSD) into the serious mental illness definition, thus requiring PTSD treatment to be covered in a group health benefit plan. The bill defines PTSD as a disorder that:

  • meets the diagnostic criteria for PTSD specified by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, or a later edition adopted by the commissioner; and
  • results in an impairment of a person's functioning the the person's community, employment, family, school, or social group. 

Vote Recommendation Notes

While we recognize the legitimacy of categorizing PTSD as a serious mental illness, and sympathize with what many of our veterans are going through, we oppose all new mandates on health insurance carriers.

Our issue with the HB 838 is that it would mandate a group health benefit plan to provide coverage for PTSD treatment. This legislation represents yet another example of the government interfering with private businesses. The high cost of health care and health insurance is partly the result of government interference in the form of mandates. Every time the government tinkers with the system to take choices away from providers and patients, costs tend to rise.

Creating new state mandates on private enterprise abridges our limited government and free market principles. Therefore, we oppose HB 838.

It is worth noting that Texas has one of the largest amounts of insurance mandates in the U.S.

Organizations Opposed

Texas Association of Business