Senate Committee on State Affairs - 81st R.S. (2009)
- Upon passage of federal legislation relating to reform of the health care industry and health insurance industry, study the implications of such legislation on Texas, the health care industry, and public and private insurance. Study and monitor the implementation of the insurance regulatory changes, changes to high risk pool, and any other insurance mandates. Study the health care policy changes and the impact to the Medicaid and CHIP programs and the state budget. Assess the impact to all state uninsured and uncompensated care programs and county programs for the uninsured, including county property tax programs to pay for the uninsured. Make recommendations for the efficient implementation of programs. (Joint charge with Senate Health and Human Services Committee)
- Monitor the actuarial and financial conditions of the pension and health care programs administered by the Teacher Retirement System and the Employees Retirement System. Assess the effectiveness of pilot programs designed to encourage the use of clinical integration, payments for good outcomes, use of best practices, focus on wellness and prevention, and bundling of costs for episodes of care, and other health care savings initiatives. Make recommendations for expanding the pilot programs for use across all private and state sponsored health care, including the Medicaid program, as a means to improve Texans' health and provide more effective care that allows for assistance for the uninsured. (SB 7, SB 8 and SB 10, 81st Legislature)
- Study the implementation of the Healthy Texas program enacted by the 81st Legislature and the ongoing implementation of SB 1731, 80th Legislature, to determine if this program is effectively lowering health insurance costs and increasing access to health insurance for small business. Study and make recommendations about using this program to increase access to health insurance for sole proprietors. Review other states efforts to lower health care costs to small business owners and sole proprietors and incentivize small business owners and sole proprietors to purchase insurance.
- Examine best practices for increasing the affordability and availability of health insurance in the individual and small group market, including medical underwriting practices, rescission of coverage, cancellation of coverage, rate regulation, and reporting of medical loss ratios.
- Study how increased out-of-pocket costs for medications and treatment impact consumers' compliance with health care recommendations and how that response impacts overall health care costs. Review available research into value design programs.
- Study ways to improve the efficiency and accuracy of voter registration rolls, including the feasibility and security of online registration and automatic registration and the accuracy of verification and purging of voters. Recommend ways to ensure that deceased or otherwise ineligible voters are not included on rolls while also ensuring that all eligible applicants are efficiently registered.
- Study the transparency of organizational structures, policies and coverage associated with health insurance underwriters/agents and the relationship between underwriters/agents and policyholders.
- Study the sale of annuities in Texas, particularly to seniors. Evaluate the requirements relating to rescission of an annuity contract, payment of surrender fees, return of money, contract forms, including a standard contract form, buyer's guide, agent's commission and disclosure of an agent's commission. Make recommendations for legislation, if needed, and consider whether the insurance commissioner by rule may limit an agent's commission.
- Study the effect Texas hospital billing and collection practices have on the uninsured's and under-insured's access to hospital health care services, on the uninsured's and underinsured's economic circumstances, and on medical debt recorded as bad debt on hospital books and records. Assess whether hospital billing disparities involving pricing discounts between the uninsured and insured exist and make recommendations for any changes necessary.
- Study the adequacy of workers' compensation benefits in the following categories: lifetime income benefits, wage benefits for the high wage earner, and workers whose wage benefits stop before Social Security benefits begin. In order to determine the impact of increased benefits in one or more of these categories, work with the Texas Department of Insurance to develop a publicly accessible model to predict the costs related to those enhanced benefits, the effect of those costs on workers' compensation premiums, and whether enrollment in the workers' compensation system will be adversely impacted by increasing the benefits in one or more of the stated categories.
- Study whether subrogation claims by writers of workers' compensation policies should be limited or prohibited. Study the effect on workers' compensation premiums, if any, if subrogation claims by writers of workers' compensation policies are limited or prohibited. Consider the feasibility of developing a publicly accessible model to predict the impact on workers' compensation premiums, if any, if subrogation claims by writers of workers' compensation policies are limited or prohibited, while protecting confidentiality as required by law and study whether the impact on workers' compensation premiums, if any, would adversely impact enrollment in the workers' compensation system.
- Study and make recommendations regarding access to voting by members of the military serving in the United States and abroad, including the feasibility of electronic delivery of ballots.
Study the Public Information Act and the Open Meetings Act to ensure that government continues to operate in a way that is open and transparent. The study should consider how advances in technology and the emergence of various forms of social media (e.g. Facebook, MySpace, Twitter) have affected communications by and within governmental bodies.
- Monitor the implementation of legislation addressed by the Senate Committee on State Affairs, 81 st Legislature, Regular and Called Sessions, and make recommendations for any legislation needed to improve, enhance, and/or complete implementation.
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