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Relating to the provision of certain benefits under Medicaid and the Healthy Texas Women program, including the transition of case management for children and pregnant women program services and Healthy Texas Women program services to a managed care program.
Estimated Two-year Net Impact to General Revenue Related Funds for HB 133, Committee Report 2nd House, Substituted: a NEGATIVE impact of ($45,761,921) through the biennium ending August 31, 2023.
The bill would make no appropriation but could provide the legal basis for an appropriation of funds to implement the provisions of the bill. The Health and Human Services Commission (HHSC) and Department of State Health Services (DSHS) are required to implement a provision of this Act only if the legislature appropriates money specifically for that purpose. If the legislature does not appropriate money for that purpose, HHSC and DSHS may, but are not required to, implement a provision of this Act using other appropriations available for that purpose.
HB 133 would require the Health and Human Services Commission to transition to a Medicaid managed care model for transition services provided to all recipients under the children and pregnant women program. This program is designed to provide case management services to children who have a health condition or health risk and pregnant women who have a high-risk condition via this new managed care model. This transition would be required to occur seamlessly. In order to accomplish this, the commission would consult with the Healthy Texas Women program, identify barriers, and designate service providers.
Women who were enrolled in the Healthy Texas Women program and have a household income that is more than 100, but not more than 200 percent, the federal poverty level would have to be given information regarding their eligibility for a premium subsidy under the Patient Protection and Affordable Care Act.
HB 133 would require the commission to study the feasibility of making this transition from the Healthy Texas Women program to this new managed care program automatic.
HB 133 would finally require the Health and Human Services Commission to continue providing medical assistance to a woman who is eligible for medical assistance for pregnant women for a period of not less than 6 months following the date the woman delivers or experiences an involuntary miscarriage.
The goal of HB 133 is to move the children and pregnant women program from a fee based model to a managed care model. Managed care models have proven to be more efficient and cost effective than their fee based counterparts, which supports our limited government principle. However we have concerns about the large fiscal note still associated with HB 133, so Texas Action remains neutral.