Bill > HB5244

This bill establishes the Texas Plan demonstration program, a comprehensive healthcare initiative designed to provide health coverage for eligible individuals aged 19-64 who are not currently Medicaid recipients. The program aims to create a more accessible and cost-effective healthcare system by providing participants with funds for primary and specialty medical care through a unique funding mechanism. Participants will receive money distributed into personal health benefit accounts, with 25% allocated for primary care services (including dental and prescription drugs) and 75% for specialty and major medical care services. The program requires seeking a federal waiver to implement, will establish a "med-pool" to manage specialty care costs, and allows participants to choose healthcare providers based on transparent pricing and quality metrics. Key features include emphasizing preventive, whole-person care, enabling telehealth services, and providing continuous coverage. The program is designed to be operational for five years, with a potential end date of September 1, 2031, and seeks to improve health outcomes by considering non-medical factors like nutrition and housing that impact individual health. The bill intends to launch the program by September 1, 2026, contingent upon obtaining necessary federal approvals.

Health and Social Services

https://capitol.texas.gov/BillLookup/History.aspx?LegSess=89R&Bill=HB5244