Bill Text: TX SB225 | 2025-2026 | 89th Legislature | Introduced

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Bill Title: Relating to implementation of an express lane option for determining eligibility and enrolling certain individuals in Medicaid or the child health plan program.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced) 2025-02-11 - Co-author authorized [SB225 Detail]

Download: Texas-2025-SB225-Introduced.html

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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.