HB 1237 -- Universal Health Assurance

Co-Sponsors:  Days, Selby, Riback Wilson (25), Bray, Dougherty,
Fraser, Graham (24), Shelton

This bill submits to the voters of the state an act proposing
the "Missouri Universal Health Assurance Program" which
establishes a single, publicly-financed health insurance
program.  A board of governors composed of 19 members
administers 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.  The surcharge paid by resident
individuals ranges from 1.2% of Missouri adjusted gross income
for those with incomes of over $5,000 but less than $25,000 to
$1,425 plus 3.6% of Missouri adjusted gross income for those
with incomes over $100,000.  The Act establishes a tax credit
for employers that employ 25 or fewer employees and requires the
Department of Insurance to reduce workers' compensation
insurance rates to reflect a reduction in the employer's
liability for medical expenses due to the Act's health care
program.

Every Missouri resident regardless of preexisting 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.