84th Texas Legislature Coverage Expansion Bills
If you’d like to stay up-to-date this session on bills related to expanding coverage, we are at your service. Below is a comprehensive list of bills aiming to close the Coverage Gap in Texas. Our state has yet to accept federal funds to help insure over one million low-income Texans. These bills offer various solutions on how to give more Texans the access to health coverage they deserve. If you have any questions, please leave them in the comments section, and we will get back to you ASAP.
Bill: SB 423
Author: Sen. Royce West
Companion Bill: HB 977 by Rep. Nicole Collier
Summary: 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.
Additional Notes:
- The expansion will cease if federal contribution to funding drops below ACA required levels
- The expansion must include cost-sharing obligations
Bill: SB 89
Author: Sen. Rodney Ellis
Summary: Relating to the expansion of eligibility for medical assistance to certain persons under the federal Patient Protection and Affordable Care Act.
Additional Notes:
- Traditional Medicaid Expansion
Bill: SB 1039
Author: Sen. Jose R Rodriguez
Summary: Relating to seeking federal authorization to provide health benefit plan coverage to certain low-income individuals through the private marketplace.
Additional Notes:
- A program to assist the expansion population with obtaining health benefit plan coverage through the private marketplace. The waiver must:
- provide for the implementation of sliding scale subsidies
- require the implementation of HSAs and cost-sharing
- include personal responsibility requirements, including incentives for seeking and maintaining employment
- impose financial penalties on individuals enrolled in the program for inappropriate use of hospital emergency room services for non-emergent care
- provide for implementation of a small-employer subsidy designed to encourage those employers to provide health benefit coverage options as a benefit to employees who are members of the expansion population
- be designed to establish a transparent process for determining the cost savings realized under the waiver by local governments and local property taxpayers that result from reduced costs associated with providing indigent care services
Bill: HB 1138
Author: Rep. Celia Israel
Coauthor: Rep. Jose Menendez
Summary: Relating to the expansion of eligibility for medical assistance to certain persons under the federal Patient Protectionand Affordable Care Act.
Additional Notes:
- Traditional Medicaid Expansion
Bill: HB 4054
Authors: Rep. Trey Martinez Fischer
Summary: Relating to a "Texas Solution" to reforming and addressing issues related to the Medicaid program, including the creation of an alternative program designed to ensure health benefit plan coverage to certain low-income individuals through the private marketplace; authorizing a fee.
Additional Notes:
- Texas would operate the current Medicaid program under a block grant if allowed to under federal law.
- the bill proposes to restructure Medicaid for the current population, adding premium subsidy options, co-pays and premium sharing, and health savings accounts. The Coverage Gap population would get coverage through a new separate program incorporating many of the same elements. Long-term services and supports would incorporate more cost-sharing requirements, and HHSC would study making LTSS eligibility more restrictive.
Bill: HB 3845
Author: Rep. Garnet Coleman
Summary: Relating to a "Texas Way" to reforming and addressing issues related to the Medicaid program, including the creation of an alternative program designed to ensure health benefit plan coverage to certain low-income individuals through the private marketplace; authorizing a fee.
Additional Notes:
- Shares several elements with HB 4054:
- Texas would operate the current Medicaid program under a block grant if allowed to under federal law.
- the bill proposes to restructure Medicaid for the current population, adding premium subsidy options, co-pays and premium sharing, and health savings accounts. The Coverage Gap population would get coverage through a new separate program incorporating many of the same elements.
Bill: HB 4000
Author: Rep. Cesar Blanco
Summary: Relating to the expansion of eligibility for Medicaid by counties under the federal Patient Protection and Affordable Care Act.
Additional Notes:
- Texas would seek a federal waiver to allow individual Texas counties to expand Medicaid, with counties providing the state’s share of coverage and administrative costs.
Bill: HB 2270
Author: Rep. Sergio Munoz Jr.
Summary: Relating to the expansion of eligibility for Medicaid in certain counties under the federal Patient Protection and Affordable Care Act.
Additional Notes:
- Similar, not identical to HB 4000
- Texas would seek a federal waiver to allow individual Texas counties to expand Medicaid, does not specify source of state’s share of costs.
Bill: HB 116
Author: Rep. Trey Martinez Fischer
Summary: Relating to expanding eligibility for benefits under the Medicaid program.
Additional Notes:
- Traditional Medicaid Expansion
Bill: HB 3195
Author: Rep. Diego Bernal
Summary: Relating to the establishment of a health care pilot program for low-income individuals.
Additional Notes:
- A pilot program to cover adults with children enrolled in Children's Medicaid under 138% FPL in certain areas of the state
- Funded using a portion of GR funds made available after the abolishment of the Texas Health Insurance Pool (SB1367, 83rd Legislature). (Note: Funds from the former “high-risk” health insurance pool are being eyed fro multiple purposes this session.)
Bill: HB 3934
Author: Rep. Cesar Blanco
Summary: Relating to Medicaid eligibility for certain residents.
Additional Notes:
- Makes medical assistance programs available to qualified aliens who have resided in the U.S. for five years, essentially removing Texas' current requirement that excludes qualified alien adults from Medicaid
- Removes five-year bar for pregnant women as allowed under CHIPRA. Today Texas only removes the five-year bar for immigrant children, not pregnant women