HB 610 -- Health Care Benefits

Co-Sponsors:  Bray, Fraser

This bill submits to the voters of the state a proposal for the
Missouri Universal Health Assurance Program, which establishes a
single, publicly-financed statewide health insurance program.  A
board of governors composed of 19 members will administer the
program and is required to establish the program's policy and
budget, control capital expenditures, set fee schedules, approve
coverage offered by the program, conduct utilization review, and
employ staff.  The board will be assisted in its policy
development activities by advisory councils in 6 regional health
policy planning and development districts to be designated by
the Director of the Department of Health.  The board and the
advisory councils must annually develop a comprehensive state
health care plan.

Funding for the comprehensive health care plan is administered
by the board through the Missouri Health Care Trust Fund.
Allocations to the fund include all federal payments received
from waivers granted under health care programs established by
the Social Security Act, appropriations by the General Assembly
to the program, health premium surcharges paid by all employers,
and health premium surcharges based on the Missouri adjusted
gross income of resident individuals.  The surcharge paid by
employers is calculated as a percentage of the total amount paid
in wages by the employer.  The percentage ranges from 5% for
employers with fewer than 5 employees to 12% for employers with
500 or more employees.  Surcharges paid by resident individuals
range from 1.2% on Missouri adjusted gross income of over $5,000
up to $25,000 to $1,425 plus 3.6% on Missouri adjusted gross
income over $100,000.  The bill establishes a tax credit for
employers that employ 25 or fewer employees.

Every Missouri resident, regardless of pre-existing conditions,
is entitled to receive covered services under the program if the
service is deemed by the patient and participating provider to
be necessary for the maintenance of physical and mental health.
Cosmetic surgery, medical examinations conducted for obtaining
life insurance or participating in a civil action, and custodial
care rendered in a nursing home are specifically excluded from
coverage.  The program will reimburse institutional providers of
inpatient services through a budget negotiated by the provider
to cover its anticipated services.  The program will reimburse
independent providers of health care services based on a fee
schedule negotiated annually with a professional association
chosen by the members of each health care profession.

The provisions of the bill become effective only upon approval
by the voters of the state and then on April 1 of the year
following notice to the Revisor of Statutes that the Department
of Social Services has obtained a waiver from the Secretary of
the U. S. Department of Health and Human Services.

Missouri House of Representatives
Last Updated September 13, 2001 at 2:03 pm