Legislative proposal designed to increase access to and decrease costs of health care

A bill introduced by Representative Jim Raussen would require the state to subsidize health insurance claims for people with chronic medical conditions and offer tax credits for poor adults that don’t qualify for Medicaid. This week, Rep. Raussen provided sponsor testimony on the legislation noting the key aspects of the bill, which includes provisions that would increase eligible age for family policy dependents from 22 to 29, offer BWC premium discounts to small businesses that don't offer insurance but meet certain criteria; subsidize the uninsured through tax credits for individuals and families; and focus reinsurance for the uninsured with chronic conditions into three categories.

The bill would also subsidize uninsured Ohioans below 100% FPL that don't qualify for Medicaid; increase salaries for nursing instructors at state universities; expand the 340b Federal Drug Pricing Program in prisons; increase the role of public dentistry and allow more flexibility in providing services; and require the Department of Education adopt nutrition rules and ban trans-fat from schools; increase purchasing of pharmaceutical benefits for state programs; and use and expand on the Governor's executive order for a Health Information Technology board.

Also included in the bill are changes in contracting language between Medicaid Managed Care companies, a request that non-profit hospitals define charitable care/community benefits; a requirement that certain hospitals post their tax liability as compared to their charitable care on their Web site; and a requirement for ambulatory surgical facilities to annually report certain data to the Director of Health.

The reinsurance plan outlined in the bill is based on the Healthy New York model, and would define participants into three high-risk categories based on the severity of their preexisting conditions. The program would begin by targeting individuals with lower levels of risk that meet certain eligibility requirements. In addition, the state would offer “stop-gap coverage” by subsidizing claims between $15,000 and $50,000 annually, a measure in the bill that would enable people with chronic conditions to purchase private insurance. The state would have authority to audit the claims.

As far as the cost of the program goes, reinsuring claims for those with preexisting conditions would initially cost between $100-150 million to implement in fiscal year 2009 and once fully implemented would likely cost between $450-$500 million annually, but the cost would be limited to the amount the state collects through the tax on insurance premiums. Under the bill, the Ohio C.A.R.E. plan would provide tax credits of $2,500 per individual and $4,000 for families living below 100% of the federal poverty level that aren’t eligible for Medicaid, he said. About 30% of the state’s uninsured fall into that category.

The AMCNO plans to review the bill in detail and provide input on the legislation. The inclusion of wellness discount programs along with the provision to adopt nutrition rules in schools and eliminate trans-fat are important public health issues, however, other key issues in the bill that will warrant the attention of the AMCNO include the changes in contracting language between Medicaid Managed Care companies, the request that non-profit hospitals define charitable care/community benefits; the requirement of certain hospitals to post their tax liability as compared to their charitable care on their Web site; the requirement that ambulatory surgical facilities annually report certain data to the Director of Health; as well as a need to review how the discounts on premiums will be implemented for BWC employers who offer health and wellness programs. Also of interest to the AMCNO will be the pilot program and advisory board that will be responsible for exploring the use of health information technology in Ohio. As the testimony on this legislation continues, the AMCNO will keep our members apprised of its’ progress in the legislature.