express lane Medicaid enrollment using SNAP and WIC data

The text as introduced · 1,010 words

89R570 SCP-D

By: West
S.B. No. 225

A BILL TO BE ENTITLED

AN ACT

relating to implementation of an express lane option for

determining eligibility and enrolling certain individuals in

Medicaid or the child health plan program.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 62.1011, Health and Safety Code, is

amended to read as follows:

Sec. 62.1011. VERIFICATION OF INCOME. (a) Except as

provided by Subsection (b) and subject to Subsection (c), the [ The ]

commission shall continue employing methods of verifying the

individual incomes of the individuals considered in the calculation

of an applicant's household income.

(b) The commission shall verify income under this section

unless the applicant reports a household income that exceeds the

income eligibility level established under Section 62.101(b).

(c) The commission may verify income using the verification

process described in Section 62.1012.

SECTION 2. Subchapter C, Chapter 62, Health and Safety

Code, is amended by adding Section 62.1012 to read as follows:

Sec. 62.1012. EXPRESS LANE OPTION ELIGIBILITY; AUTOMATIC

ENROLLMENT. (a) In this section:

(1) "Express lane agency" means a governmental entity

that:

(A) determines eligibility for assistance under

a public assistance program of this state; and

(B) the executive commissioner designates as

capable of making determinations of one or more eligibility

requirements under the child health plan program.

(2) "Public assistance program" includes:

(A) the Medicaid program under Chapter 32, Human

Resources Code;

(B) the financial assistance program under

Chapter 31, Human Resources Code;

(C) the nutritional assistance programs under

Chapter 33, Human Resources Code, including the supplemental

nutrition assistance program under that chapter;

(D) the federal special supplemental nutrition

program for women, infants, and children authorized by 42 U.S.C.

Section 1786;

(E) the federal Head Start program established

under 42 U.S.C. Section 9831 et seq.; and

(F) the free or reduced-price lunch program

established under 42 U.S.C. Section 1751 et seq.

(b) Notwithstanding any other law and in accordance with

Sections 1902(e)(13) and 2107(e)(1)(H) of the Social Security Act

(42 U.S.C. Sections 1396a(e)(13) and 1397gg(e)(1)(H)), the

commission shall implement an express lane option under which the

commission may use information obtained by an express lane agency

to determine a child's eligibility for coverage under the child

health plan, including a child's eligibility for reenrollment in

the plan.

(c) In accordance with Section 1902(e)(13)(D) of the Social

Security Act (42 U.S.C. Section 1396a(e)(13)(D)), the commission

shall automatically enroll in the child health plan program a child

who is determined to be eligible for the program under this section.

SECTION 3. Sections 32.026(e) and (g), Human Resources

Code, are amended to read as follows:

(e) The executive commissioner shall permit a

recertification review of the eligibility and need for medical

assistance of a child under 19 years of age to be conducted by

telephone or mail instead of through a personal appearance at an

office, unless the commission determines that the information

needed to verify eligibility cannot be obtained in that manner or

may be obtained in the manner specified by Section 32.026102 . The

executive commissioner by rule may develop procedures to determine

whether there is a need for a recertification review of a child

described by this subsection to be conducted through a personal

interview with a commission representative. Procedures developed

under this subsection shall be based on objective, risk-based

factors and conditions and shall focus on a targeted group of

recertification reviews for which there is a high probability that

eligibility will not be recertified.

(g) Notwithstanding any other provision of this code, the

commission may use information obtained from a third party to

verify the assets and resources of a person for purposes of

determining the person's eligibility and need for medical

assistance to the extent that verification is applicable under

federal law. Third-party information includes information

obtained from:

(1) a consumer reporting agency, as defined by Section

20.01, Business & Commerce Code;

(2) an appraisal district; [ or ]

(3) the Texas Department of Motor Vehicles vehicle

registration record database ; or

(4) an express lane agency described by Section

32.026102 .

SECTION 4. Subchapter B, Chapter 32, Human Resources Code,

is amended by adding Section 32.026102 to read as follows:

Sec. 32.026102. EXPRESS LANE OPTION; AUTOMATIC ENROLLMENT.

(a) In this section:

(1) "Express lane agency" means a governmental entity

that:

(A) determines eligibility for assistance under

a public assistance program of this state; and

(B) the executive commissioner designates as

capable of making determinations of one or more eligibility

requirements under the medical assistance program.

(2) "Public assistance program" includes:

(A) the child health plan program under Chapters

62 and 63, Health and Safety Code;

(B) the financial assistance program under

Chapter 31;

(C) the nutritional assistance programs under

Chapter 33, including the supplemental nutrition assistance

program under that chapter;

(D) the federal special supplemental nutrition

program for women, infants, and children authorized by 42 U.S.C.

Section 1786;

(E) the federal Head Start program established

under 42 U.S.C. Section 9831 et seq.; and

(F) the free or reduced-price lunch program

established under 42 U.S.C. Section 1751 et seq.

(b) Notwithstanding any other law and in accordance with

Section 1902(e)(13) of the Social Security Act (42 U.S.C. Section

1396a(e)(13)), the commission shall implement an express lane

option under which the commission may use information obtained by

an express lane agency to determine an individual's eligibility for

medical assistance, including the recertification of an

individual's eligibility for medical assistance benefits.

(c) In accordance with Section 1902(e)(13)(D) of the Social

Security Act (42 U.S.C. Section 1396a(e)(13)(D)), the commission

shall automatically enroll in the medical assistance program an

individual who is determined to be eligible for the program under

this section.

SECTION 5. If before implementing any provision of this Act

a state agency determines that a waiver or authorization from a

federal agency is necessary for implementation of that provision,

the agency affected by the provision shall request the waiver or

authorization and may delay implementing that provision until the

waiver or authorization is granted.

SECTION 6. This Act takes effect September 1, 2025.