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Texas Statutes (Last Updated: January 4, 2014) |
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HEALTH AND SAFETY CODE |
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Title 2. HEALTH |
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Subtitle C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES |
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Chapter 62. CHILD HEALTH PLAN FOR CERTAIN LOW-INCOME CHILDREN |
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Subchapter C. ELIGIBILITY FOR COVERAGE UNDER CHILD HEALTH PLAN |
Sec. 62.101. ELIGIBILITY
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(a) A child is eligible for health benefits coverage under the child health plan if the child:
(1) is younger than 19 years of age;
(2) is not eligible for medical assistance under the Medicaid program;
(3) is not covered by a health benefits plan offering adequate benefits, as determined by the commission;
(4) has a family income that is less than or equal to the income eligibility level established under Subsection (b); and
(5) satisfies any other eligibility standard imposed under the child health plan program in accordance with 42 U.S.C. Section 1397bb, as amended, and any other applicable law or regulations.
(a-1) A child who is the dependent of an employee of an agency of this state and who meets the requirements of Subsection (a) may be eligible for health benefits coverage in accordance with 42 U.S.C. Section 1397jj(b)(6) and any other applicable law or regulations.
(b) The commission shall establish income eligibility levels consistent with Title XXI, Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended, and any other applicable law or regulations, and subject to the availability of appropriated money, so that a child who is younger than 19 years of age and whose net family income is at or below 200 percent of the federal poverty level is eligible for health benefits coverage under the program. In addition, the commission may establish eligibility standards regarding the amount and types of allowable assets for a family whose net family income is above 150 percent of the federal poverty level.
(b-1) The eligibility standards adopted under Subsection (b) related to allowable assets:
(1) must allow a family to own at least $10,000 in allowable assets; and
(2) may not in calculating the amount of allowable assets under Subdivision (1) consider:
(A) the value of one vehicle that qualifies for an exemption under commission rule based on its use;
(B) the value of a second or subsequent vehicle that qualifies for an exemption under commission rule based on its use if:
(i) the vehicle is worth $18,000 or less; or
(ii) the vehicle has been modified to provide transportation for a household member with a disability;
(C) if no vehicle qualifies for an exemption based on its use under commission rule, the first $18,000 of value of the highest valued vehicle; or
(D) the first $7,500 of value of any vehicle not described by Paragraph (A), (B), or (C).
(c) The commissioner shall evaluate enrollment levels and program impact every six months during the first 12 months of implementation and at least annually thereafter and shall submit a finding of fact to the Legislative Budget Board and the Governor's Office of Budget and Planning as to the adequacy of funding and the ability of the program to sustain enrollment at the eligibility level established by Subsection (b). In the event that appropriated money is insufficient to sustain enrollment at the authorized eligibility level, the commissioner shall:
(1) suspend enrollment in the child health plan;
(2) establish a waiting list for applicants for coverage; and
(3) establish a process for periodic or continued enrollment of applicants in the child health plan program as the availability of money allows.