HBA-MSH, CCH C.S.H.B. 1087 77(R)BILL ANALYSIS Office of House Bill AnalysisC.S.H.B. 1087 By: Coleman Public Health 3/19/2001 Committee Report (Substituted) BACKGROUND AND PURPOSE Some disabled individuals who are capable of working may choose not to work because they lose their Supplemental Security Income (SSI) and Medicaid eligibility if they earn more than a certain income. Often, people with disabilities who lose Medicaid benefits cannot afford private insurance plans. The federal Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA) authorizes states to allow people with disabilities to buy into the Medicaid program thereby removing an obstacle for them to sustain employment. C.S.H.B.1087 requires the Health and Human Services Commission to develop and implement a medical buy-in pilot project, under TWWIIA, so that employed disabled individuals can receive Medicaid coverage. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS C.S.H.B. 1087 amends the Human Resources Code to require the Health and Human Services Commission (HHSC) to establish a demonstration project to implement in three sites a medical assistance buy-in program in accordance with the federal Ticket to Work and Work Incentives Improvement Act (TWWIIA) of 1999. The project provides medical assistance to an employed individual with a medically improved disability, who is at least 16 years of age but not older than 64 years of age, and has an earned income that exceeds the limit to receive Supplemental Security Income (SSI), but is otherwise eligible to receive SSI. C.S.H.B. 1087 authorizes HHSC to establish income, assets, and resource limitations for participation in the demonstration project. The bill provides that project participants may pay premiums and other cost-sharing charges based on income in accordance with federal welfare law. The bill requires HHSC to evaluate the effectiveness of the demonstration project in providing health care services to employed persons with disabilities no later than December 1, 2002. If the results indicate that the project is effective, HHSC is required to incorporate a funding request for the continuation of the program in HHSC's budget request for the next state fiscal biennium. The bill requires HHSC to request and actively pursue the award of a federal grant authorized by the TWWIIA to support the design, establishment, and operation of infrastructures in the state that provide support services for employed persons with disabilities. EFFECTIVE DATE September 1, 2001. COMPARISON OF ORIGINAL TO SUBSTITUTE C.S.H.B. 1087 differs from the original by requiring the Health and Human Services Commission (HHSC) to implement the pilot program in three sites and requiring HHSC to apply for and actively pursue the award of a federal grant authorized by TWWIIA.