Will Texas Consider Feasibility of Reference Based Pricing Strategies for Public Educators?

               $64,000 Question

House Bill 3987, if passed, will direct a commission to study alternative mechanisms for offering health benefit plan coverage to the affected employees  of the TRS ActiveCare program and their dependents. Will “alternative mechanisms” include a study of Reference Based Pricing strategies? Will Texas follow the lead of Montana, North Carolina and the South Texas Health Cooperative? 

The South Texas Health Cooperative is a risk pool of participating school districts that has moved from the world of managed care to Reference Based Pricing  more than seven years ago with good success. The pool has enjoyed static rates since the move to reference based pricing, while improving benefits at the same time.

Meanwhile, back at the ranch, member districts of the TRS ActiveCare program with +400,000 members continues to experience annual cost increases, less choice, and benefit erosion……………..

We noticed the commission members will not include anyone from the medical community. The commission is to report it’s findings in January 2021.

By: Leach            H.B. No. 3987

A BILL TO BE ENTITLED

AN ACT

relating to the creation of a study of  TRS  – ActiveCare  administered

by the Teacher Retirement System of Texas.

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

SECTION 1.  COMMITTEE. (a)  A committee is created to study

and review  TRS  – ActiveCare  , administered under Chapter 1579,

Insurance Code, and propose reforms to address issues described by

Section 2 of this Act.

(b)  The committee is composed of the following members:

(1)  two persons appointed by the governor;

(2)  two persons appointed by the lieutenant governor;

(3)  two persons appointed by the speaker of the house

of representatives; and

(4)  two persons employed by the Teacher Retirement

System of Texas and appointed by the board of trustees of the

system.

SECTION 2.  STUDY REGARDING CERTAIN HEALTH BENEFIT PLANS.

The committee created by Section 1 of this Act shall study

TRS  – ActiveCare  to examine and assess the following issues:

(1)  the financial soundness of the plans offered under

TRS  – ActiveCare  ;

(2)  the cost and affordability of plan coverage to

persons eligible for coverage under the plans;

(3)  the sufficiency of access to physicians and health

care providers under the plans; and

(4)  alternative mechanisms for offering health

benefit plan coverage to the affected employees and the affected

employees’ dependents.

SECTION 3.  COMMITTEE FINDINGS AND RECOMMENDATIONS.  (a)

Not later than January 15, 2021, the committee appointed under this

Act shall report the committee’s findings and recommendations to

the lieutenant governor, the speaker of the house of

representatives, and the governor. The committee shall include in

its recommendations specific statutory and regulatory changes that

appear beneficial from the results of the committee’s study under

Section 2 of this Act.

(b)  Not later than the 60th day after the effective date of

this Act, the governor, lieutenant governor, speaker of the house

of representatives, and board of trustees of the Teacher Retirement

System of Texas shall appoint the members of the committee created

under Section 1 of this Act in accordance with that section.

SECTION 4.  ABOLITION OF COMMITTEE. The committee created

by this Act is abolished and this Act expires January 20, 2021.

SECTION 5.  EFFECTIVE DATE.  This Act takes effect

immediately if it receives a vote of two-thirds of all the members

elected to each house, as provided by Section 39, Article III, Texas

Constitution.  If this Act does not receive the vote necessary for

immediate effect, this Act takes effect September 1, 2019.

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