HB 1919 – This bill expands the existing mandated benefit for treatment of Acquired Brain Injury (ABI) to include outpatient day treatment services or other equivalent post-acute care treatment services.

With most companies, like Blue Cross Blue Shield of Texas, outpatient day treatment service and other post-acute care treatment services had been covered under the existing ABI benefit provisions. In order to completely comply with the new law, amendments have been developed to expand and include these services into the definition of ABI.

HB 2548 – Currently, members receive pre-existing credit for prior group, government or church coverage when purchasing an individual health policy. This bill provides the same credit for an individual policy and now allows the member to transfer credit from one individual policy to another.

Companies that haven’t made this change will be sending out amendments to insureds.  Some companies, like Blue Cross Blue Shield of Texas, made this administrative change already.  Blue Cross Blue Shield of Texas made the change effective July 1, 2007, prior to the passing of this bill and amendments have been developed to align the policy language to the new law/procedural change already implemented.

The legislation also provides a 0.5 percent increase for Medicare doctors for six months, delaying a scheduled 10 percent pay cut.

Bush twice vetoed more ambitious earlier bills that would have expanded the children’s health program to cover about 10 million children in low and moderate income families, despite bipartisan support.

Bush and Democrats have been locked in a fight over budget and spending and the president said the previous bills were too costly and would push more children into government-run health care instead of private health insurance plans.

The most interesting part of the whole plan is who is offering the coverage… private Texas health insurance companies.  As a result, safety-net hospitals like Parkland Memorial Hospital in Dallas are wary of the effect of shifting money into the pockets of health insurance companies.

If you take the money away from the large safety-net hospitals … and put it into insurance companies, they may dissipate the patients everywhere.

said Ron Anderson, Parkland’s president and chief executive officer.

If the federal government approves the plan, the working poor who are 19 years or older can apply for subsidized coverage through the “Health Opportunity Pool” starting next fall.  Last spring, lawmakers approved an extra $150 million of state money to increase reimbursements for hospitals that treat Medicaid patients.  The federal government will match that increase with $246 million of federal funds.

The restrictions on Medicaid in Texas are so strict right now that a working parent with two children making more than $308/month would not qualify.  I guess the state of Texas expects them to take the $309/month they do make and put 60% of it towards a health insurance premium.

Under the new Health Opportunity Pool, a working parent of two could earn up to $2,862/month and still be eligible for subsidized health insurance coverage through private insurers.  Applicants will be helped on a first come first served basis until funds run out.

Do You Want to Help the Poor? Go To A Strip Club!!

A new Texas state tax of $5 per customer will go toward a new state sex assault prevention fund.  Over the next two years, the fee is expected to raise $87 million, $25 million of that will go to the sex assault prevention fund and the rest will go to the Texas Health Opportunity Pool.

I had to make a decision to find a revenue source for issues important to me.  It won’t impact business and will serve a good cause.

said Senator Royce West, (D)Dallas, who sponsored the bill in the senate.