HBA-ATS H.B. 1919 76(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 1919
By: Gallego
Insurance
3/22/1999
Introduced



BACKGROUND AND PURPOSE 

Health insurance mandates require insurers and managed care plans to
provide specific benefits, treatments, and services to individuals who
participate in their health care plans.  Although mandates provide more
comprehensive care by specifying the type of care that must be provided,
there are risks associated with mandating certain health benefits.  One
concern is that mandated health benefits may require services that are not
essential to maintain good health.  Another concern is that they may
increase health costs, including insurance premiums, because insurers will
have to raise prices to offset expenditures for meeting mandated
provisions.  Consumers faced with higher insurance premiums may decline
coverage completely or seek alternatives.  In addition, increased costs may
make it difficult for small firms to provide insurance packages to their
employees. 

H.B. 1919 requires the Texas Health Care Information Council to provide a
written analysis of a proposed mandate if requested to do so by certain
members of the legislature or certain legislative agencies.  This bill also
creates the Health Benefit Mandate Review Board (board) to analyze existing
mandates.  The board is required to recommend to the legislature whether
existing mandates should be retained, revised, or eliminated. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the commissioner of insurance in
SECTION 1.01 (Article 3.97-2, Insurance Code) of this bill. 

SECTION BY SECTION ANALYSIS

ARTICLE 1.  REVIEW OF AND LIMITATIONS ON HEALTH CARE BENEFIT MANDATES

SECTION 1.01.  AMENDMENT.  Amends Chapter 3, Insurance Code, by adding
Subchapter K, as follows: 

SUBCHAPTER K.  REVIEW AND IMPLEMENTATION OF HEALTH CARE BENEFIT MANDATES

Art. 3.97-1.  DEFINITIONS.  Defines "council," "health benefit plan,"
"health care benefit mandate," and "offer of coverage mandate." 

Art. 3.97-2.  IMPLEMENTATION BY COMMISSIONER.  (a) Requires the
commissioner of insurance (commissioner) to strictly construe a health
benefit mandate (mandate) and adopt rules to implement a mandate in strict
compliance with state or federal law. 

Art. 3.97-3.  ANALYSIS BY TEXAS HEALTH CARE INFORMATION COUNCIL.  (a)
Requires the Texas Health Care Information Council (council) to provide a
written analysis of a proposed mandate if requested to do so by certain
elected officials or legislative agencies. 

(b) Enumerates the criteria required to be considered by the council when
it analyzes a proposed mandate. 
 
SECTION 1.02.  EFFECTIVE DATE.  Effective date of this article: September
1, 1999. 

ARTICLE 2.  HEALTH CARE BENEFIT MANDATE REVIEW BOARD

SECTION 2.01.  DEFINITIONS.  Defines "board," "commissioner," "health
benefit plan," "health care benefit mandate," and "offer of coverage
mandate." 

SECTION 2.02.  POWERS AND DUTIES.  (a) Establishes the composition of the
Health Benefit Mandate Review Board (board). 

(b) Authorizes the board to appoint committees, employ staff, and enter
into contracts with public and private entities for the collection and
analysis of data. 


(c) Provides that a member of the board is not entitled to receive
compensation, but is entitled to reimbursement for travel expenses incurred
while conducting board business. 

(d) Requires appointments to the board to be made without regard to race,
color, disability, sex, religion, age, or national origin.  Requires the
governor to consider geographical consideration when making appointments to
the board. 

SECTION 2.03.  REVIEW OF EXISTING HEALTH CARE BENEFIT MANDATES.  (a)
Enumerates the criteria required to be considered by the board when it
analyzes each mandate. 

(b) Authorizes the board to adopt additional criteria.

(c) Requires the board to recommend that, if the benefit of a mandate
exceeds its cost, the mandate should be retained.  Requires the board to
recommend that, if the cost of a mandate exceeds its benefit, the mandate
should be eliminated or revised. 

(d) Requires the board to issue a written report of its recommendations for
the retention, elimination, or revision of each mandate that is in effect
or that becomes effective before January 1, 2001, and to distribute that
report to certain elected officials.  Requires the board to publish the
report on the Internet. 

(e) Requires the board, by January 1, 2001, to complete its review of each
mandate that is in effect or that becomes effective before January 1, 2001. 

SECTION 2.04.  EFFECTIVE DATE; EXPIRATION.  Effective date of this article:
September 1, 1999.  Provides that the board is abolished and this article
expires December 31, 2001. 

ARTICLE 3.  EMERGENCY

SECTION 3.01.  EMERGENCY.  Emergency clause.