85R14756 SCL-F     By: Watson S.B. No. 2002       A BILL TO BE ENTITLED   AN ACT   relating to regional or local health care programs for eligible   individuals and employees of small employers.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  The heading to Chapter 75, Health and Safety   Code, is amended to read as follows:   CHAPTER 75. REGIONAL OR LOCAL HEALTH CARE PROGRAMS FOR ELIGIBLE   INDIVIDUALS AND EMPLOYEES OF SMALL EMPLOYERS          SECTION 2.  Section 75.001, Health and Safety Code, is   amended to read as follows:          Sec. 75.001.  PURPOSE. The purpose of this chapter is to:                (1)  improve the health of eligible individuals and   employees of small employers and their families by improving the   individuals' and employees' access to health care and by reducing   the number of those individuals and employees who are uninsured;                (2)  reduce the likelihood that those individuals and    employees and their families will require services from   state-funded entitlement programs such as Medicaid;                (3)  contribute to economic development by helping   small businesses remain competitive with a healthy workforce and   optional health care benefits that will attract employees; and                (4)  encourage innovative solutions for providing and   funding health care services and benefits.          SECTION 3.  Section 75.002, Health and Safety Code, is   amended by amending Subdivisions (1), (3), and (4) and adding   Subdivision (1-a) to read as follows:                (1)  "Eligible individual" means an individual   eligible for participation in a regional or local health care   program established under this chapter.                (1-a) "Employee" means an individual employed by an   employer. The term includes a partner of a partnership and the   proprietor of a sole proprietorship.                (3)  "Local health care program" means a local health   care program operating in one county and established for the   benefit of eligible individuals and the employees of small   employers under Subchapter B.                (4)  "Regional health care program" means a regional   health care program operating in two or more counties and   established for the benefit of eligible individuals and the   employees of small employers under Subchapter B.          SECTION 4.  Sections 75.052 and 75.053, Health and Safety   Code, are amended to read as follows:          Sec. 75.052.  GOVERNANCE OF PROGRAM. (a) [A regional health   care program may be operated subject to the direct governance of the   commissioners courts of the participating counties. A local health   care program may be operated subject to the direct governance of the   commissioners court of the participating county.]  A regional or   local health care program must [may] be operated by a [joint   council,] tax-exempt nonprofit entity[, or other entity that:                [(1)     operates the program under a contract with the   commissioners court or courts, as applicable; or                [(2)     is an entity in which the county or counties   participate or that is established or designated by the   commissioners court or courts, as applicable, to operate the   program].          (b)  An [In selecting an] entity operating [described by   Subsection (a)(1) or (2) to operate] a regional or local health care   program must [, the commissioners court or courts, as applicable,   shall require, to the extent possible, that the entity] be   authorized under federal law to accept donations on a basis that is   tax-deductible or otherwise tax-advantaged for the contributor.          Sec. 75.053.  OPERATION OF PROGRAM. A regional or local   health care program provides health care services or benefits to   eligible individuals and the employees of participating small   employers who are located within the boundaries of the   participating county or counties, as applicable. A program may   also provide services or benefits to the dependents of those   individuals and employees.          SECTION 5.  Subchapter B, Chapter 75, Health and Safety   Code, is amended by adding Section 75.0545 to read as follows:          Sec. 75.0545.  PARTICIPATION BY ELIGIBLE INDIVIDUALS; SHARE   OF COST. Subject to Section 75.153, the governing body may   establish criteria for participation in a regional or local health   care program by eligible individuals and their dependents. The   criteria must require that participating individuals pay a share of   the premium or other cost of the program.          SECTION 6.  Section 75.055(c), Health and Safety Code, is   amended to read as follows:          (c)  A governing body shall actively solicit gifts, grants,   and donations to:                (1)  fund services and benefits provided under the   regional or local health care program; and                (2)  reduce the cost of participation in the program   for eligible individuals and for small employers and their   employees.          SECTION 7.  Section 75.101, Health and Safety Code, is   amended to read as follows:          Sec. 75.101.  ALTERNATIVE PROGRAMS AUTHORIZED; PROGRAM   OBJECTIVES. In developing a regional or local health care program,   a governing body may provide health care services or benefits as   described by this subchapter or may develop another type of program   to accomplish the purposes of this chapter. A regional or local   health care program must be developed, to the extent practicable,   to:                (1)  reduce the number of individuals without health   benefit plan coverage [within the boundaries of the participating   county or counties];                (2)  address rising health care costs and reduce the   cost of health care services or health benefit plan coverage [for   small employers and their employees within the boundaries of the   participating county or counties];                (3)  promote preventive care and reduce the incidence   of preventable health conditions, such as heart disease, cancer,   and diabetes and low birth weight in infants;                (4)  promote efficient and collaborative delivery of   health care services;                (5)  serve as a model for the innovative use of health   information technology to promote efficient delivery of health care   services, reduce health care costs, and improve the health of the   community; and                (6)  provide fair payment rates for health care   providers, to the extent applicable.          SECTION 8.  Sections 75.102(a), (c), and (d), Health and   Safety Code, are amended to read as follows:          (a)  A regional or local health care program may provide   health care benefits to eligible individuals and the employees of   small employers by purchasing or facilitating the purchase of   health benefit plan coverage for those individuals and employees   from a health benefit plan issuer, including coverage under:                (1)  a small employer health benefit plan offered under   Chapter 1501, Insurance Code;                (2)  a standard health benefit plan offered under   Chapter 1507, Insurance Code; or                (3)  any other health benefit plan available in this   state.          (c)  Notwithstanding Chapter 1251, Insurance Code, an   insurer may issue a group accident and health insurance policy,   including a group contract issued by a group hospital service   corporation, to cover eligible individuals and the employees of   small employers participating in a regional or local health care   program. The group policyholder of a policy issued in accordance   with this subsection is the governing body or the designee of the   governing body.          (d)  A health maintenance organization may issue a health   care plan to cover eligible individuals and the employees of small   employers participating in a regional or local health care program.   The group contract holder of a contract issued in accordance with   this subsection is the governing body or the designee of the   governing body.          SECTION 9.  Sections 75.104(a) and (c), Health and Safety   Code, are amended to read as follows:          (a)  A regional or local health care program may contract   with health care providers within the boundaries of the   participating county or counties to provide health care services   directly to eligible individuals, the employees of participating   small employers, and the dependents of those individuals and    employees.          (c)  A governing body that operates a regional or local   health care program under this section may require that   participating eligible individuals, employees, and dependents   obtain health care services only from health care providers that   contract to provide those services under the program and may limit   the health care services provided under the program to services   provided within the boundaries of the program's service area   [participating county or counties].          SECTION 10.  This Act takes effect September 1, 2017.