WeVote
Log In

Bill

Bill

HB 4046

Relating to an enrollee's cost-sharing liability for emergency care under a health benefit plan.

89th Legislature (2025) Introduced by Mary González

HB 4046 modifies Texas health insurance cost-sharing rules for emergency care to potentially reduce patient out-of-pocket expenses during medical emergencies.

Referred to Insurance
#healthcareproviders(i0387) #insurance--health&accident(i0422)
0
WeVote Research Nonpartisan
Bill Summary · HB 4046

Legislative bill overview

HB 4046 addresses how health insurance plans calculate patient out-of-pocket costs for emergency room care. The bill appears to modify cost-sharing requirements (copays, coinsurance, deductibles) that enrollees must pay when receiving emergency medical services, though the specific mechanism requires review of bill language.

Why is this important

Emergency care costs represent a significant financial burden for patients and a policy concern because patients cannot shop for providers during emergencies. How cost-sharing is structured affects both patient access to emergency care and insurance plan pricing, with downstream effects on premiums and healthcare affordability.

Potential points of contention

  • In-network vs. out-of-network rates: Determining whether emergency care cost-sharing should differ based on provider network status, which affects both patient bills and insurer payment obligations
  • Balance billing protections: Whether the bill adequately protects patients from unexpected bills when emergency providers are out-of-network
  • Insurance industry costs: Insurers may oppose limits on cost-sharing as it increases their expenses and could raise premium costs
  • Scope of coverage: Disagreement over which services qualify as "emergency" and thus fall under modified cost-sharing rules

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.