Bill Caption

Relating to presumptive eligibility for the Medicaid and child health plan programs for certain children.

Fiscal Notes

No significant fiscal implication to the State or units of local government is anticipated.

According to HHSC, there would be one-time costs for modifications to the Texas Integrated Eligibility and Redesign System (TIERS) and additional costs to provide Medicaid or CHIP benefits to eligible children. It is assumed that the number of children who would be found presumptively eligible and later determined ineligible for the programs would be small. There could also be an increase to the number of children enrolled in the programs who were previously eligible but unenrolled. Absent significant outreach, it is assumed that any cost associated with implementing the provisions of the bill would not be significant.

Bill Analysis

5/20/15 Update:

The adoption of a floor amendment in the House substantively changed this legislation by eliminating the presumptive eligibility provisions. We no longer oppose this bill.

Original Analysis:

The bill would amend the Human Resources Code and Health and Safety Code by requiring the executive commissioner of the Health and Human Services Commission (HHSC) to adopt rules providing for presumptive eligibility for Medicaid and the Children's Health Insurance Program (CHIP) for children released from certain juvenile justice settings. The adopted rules would be required to:

1. authorize only a juvenile facility for the placement, detention, or commitment of a child under Title 3, Family Code, to serve as a qualified entity and make a presumptive eligibility determination for the child health plan program for a child; and
2. identify the services and benefits, which must include mental health and substance abuse services, prescription drug benefits, and primary care services, that a child who is presumptively eligible for the child health plan program may receive under that program.

The agency would be directed to seek any necessary federal waiver or authorization and could delay implementation of any provision until such waiver or authorization is granted. 

Vote Recommendation Notes

5/20/15

Due to an amendment adopted in the House, our original objection to this legislation has been relieved. We have revised our position to neutral on HB 839

Original First Chamber Recommendation Below:

Texas currently terminates, rather than suspends, a juvenile's Medicaid benefits when a juvenile enters a detention facility, causing an interruption in the reinstatement of benefits after the juvenile is released from detention. Presumptive eligibility is a process by which a qualified entity would determine if an individual is eligible for short term coverage while his or her application for Medicaid is being processed. Authorizing presumptive eligibility would help close a juvenile's health coverage gap.

However, authorizing presumptive eligibility would increase Medicaid benefits as subsidized by the government, and consequently, taxpayers. Increasing the cost of government abridges our limited government principle. We oppose HB 839.