HB 1641 -- Missouri Universal Health Assurance Program

Sponsor:  Brown (50)

This bill establishes the Missouri Universal Health Assurance
Program which is a publicly financed, statewide program to
provide comprehensive necessary health, mental health, and dental
care services and preventive screenings for Missouri residents.

The Director of the Department of Health and Senior Services is
required to divide the population of the state into six regional
health planning and policy development districts with
approximately equal population.  An advisory council of nine
members appointed by the Governor will be established for each
district.  The advisory councils will assist the board of
governors of the program in developing an annual comprehensive
state health care plan and a transportation plan for indigent,
elderly, and disabled clients to access necessary nonemergency
health care services.

The program will be administered by a 23-member board of
governors, 14 of whom will be appointed by the Governor, with the
advice and consent of the Senate.  The directors of the
departments of Social Services, Health and Senior Services, and
Mental Health will be ex-officio members; and the board will
include minority and disabled individuals as well as health
professionals.  The board's responsibilities will include
monitoring expenditures, adopting rules, employing staff, and
studying methods for incorporating institutional and long-term
care benefits into the program.  The board is also required to
submit an annual report to the Speaker of the House of
Representatives, the President Pro Tem of the Senate, and the
Governor on the program's activities and recommendations for
changes in insurance and health care laws to improve access to
health care.

Prior to the implementation of the comprehensive plan, the board
is required to appoint advisory subcommittees of medical
professionals and medical and health care ethics experts to
conduct hearings to gather public comment.  The comprehensive
plan is required to seek the most cost-effective delivery of
health care services.

The bill also creates the Missouri Health Care Trust Fund to be
used to finance the program using federal funds.  Moneys in the
fund are not subject to appropriation or allotment by the state
or any political subdivision of the state.  Various accounts are
created within the fund for specific purposes.

Every person who is a resident of Missouri, regardless of
pre-existing conditions, will be eligible to receive benefits for
covered services.  Individuals who are not residents but are
employed in Missouri and pay the health assurance premium will be
eligible for benefits.  The board is required to request that the
program be made available to federal employees and retirees while
they are residents of Missouri.  Certain health care services are
excluded from coverage.

No participating provider can refuse to furnish services to an
eligible person on the basis of race, color, income level,
national origin, religion, sex, sexual orientation, or other
nonmedical criteria.

The program is required to pay the expenses of institutional
providers of health care, and each provider is required to
negotiate an annual budget with the program which will cover
anticipated expenses.  The program will reimburse independent
providers of health care on a fee-for-service basis using the
federal Medicare reimbursement fees as a guideline.  Other
insurers and employers may offer benefits that do not duplicate
services offered by the program.

To finance the program, every Missouri resident is required to
pay a health assurance tax based on the person's Missouri
adjusted gross income which will be collected by the Department
of Revenue and deposited into the trust fund.  If a federal
universal health program is implemented, the tax must be
decreased as specified in the bill.

No later than 30 days after the effective date of the bill, the
Department of Social Services is required to apply to the United
States Secretary of Health and Human Services for all health care
program waivers that will allow the state to deposit federal
funds into the trust fund.  The department is also required to
identify other federal funding sources.

The program will become effective April 1 of the year following
the award of a waiver by the United States Department of Health
and Human Services.  Notice of the receipt of the waiver must be
given to the Missouri Revisor of Statutes.

Missouri House of Representatives
95th General Assembly, 2nd Regular Session
Last Updated September 14, 2010 at 3:11 pm