SB 1067 - This act establishes the Missouri Universal Health Assurance Program.

The Program is a publicly-financed, statewide insurance program that will provide comprehensive health care coverage for Missouri residents. It is a corporate body (Sections 354.750 - 354.753).

The Director of the Department of Health will divide the population of the state into six regional districts, with an advisory council of 13 private citizens established for each district. The advisory councils will assist the Board in development of a comprehensive state health care plan and will develop a transportation plan for indigent, elderly, and disabled clients (Section 354.756).

The Program will be administered by a 23-member Board of Governors, 14 of which will be appointed by the Governor. The directors of the Departments of Social Services, Health and Senior Services, and Mental Health will be ex-officio members and the Board shall include a sufficient representation of minority and disabled individuals and at least 48% shall be women. The Board will be responsible for implementing the Program, monitoring expenditures, adopting rules, employing staff, and studying the means of incorporating institutional long-term care benefits into the Program. An annual report will be required after conducting investigations and utilization reviews (Sections 354.759 - 354.762).

An annual comprehensive state health care plan should be established by the Board and should include a budget, an evaluation of district health care needs, and goals for various parts of the Program. Prior to establishment, the Board should appoint advisory subcommittees of health care research and ethics experts and public hearings should be held. The resulting comprehensive health care plan should seek to secure the most cost-effective health care (Sections 354.765 - 354.768).

The Board should establish the "Missouri Health Care Trust Fund" which will be used for all aspects of Program operation. Revenues held in the trust fund are not subject to appropriation or allotment by the State or any political subdivision of the State. The "Prevention Account" and the "Health Services Account" will be created within the trust fund for specific purposes (Sections 354.771 - 354.780).

Every person who is a resident of Missouri, regardless of preexisting conditions, will be eligible to receive benefits for covered services under the Program. Persons who are not residents, but who are employed in Missouri will be eligible for benefits if a health premium surcharge is paid. Certain services, as listed, will not be covered under this Program (Sections 354.783 - 354.789).

The Program shall pay the expenses of institutional providers of health care and each provider shall negotiate an annual budget with the Program to 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 those offered by the Program (Sections 354.792 - 354.795).

A health premium surcharge, in addition to the state income tax, will be imposed on residents' gross income (Section 354.804).

No later than 30 days after the effective date of this act, the Department of Social Services shall apply to the United States Secretary of Health and Human Services for all health care program waivers that would enable the state to deposit federal funds into the Missouri health care trust fund. The Department should also identify other federal fund sources. Under the same time frame, the Governor shall appoint Board members (Sections 354.807 - 354.810).

The Board shall request that the Program be made available to federal employees and retirees while they are residents of Missouri (Section 354.813).

This act has a conditional effective date and will be submitted to the voters of the state for approval or rejection in November 2004.

This act is similar to SB 23 (2003).
LORIE TOWE