Health Insurance Care Reform 7/9/09 EasyToInsureME

DISTRICT OF COLUMBIA Health Insurance : The District Council is considering extending its legislative session past its normal July 14 recess date due to the recent announcement by the chief financial officer that the expected 2009 fiscal year revenue is now projected to be $190 million less than was estimated in February. This development will force the Council to borrow from the $1.4 billion rainy day fund in order to balance the budget as required by law.

The Council passed an amendment to the Health Occupations Revision Act that included a definition of "the practice of medicine." As passed, the provision does not contain language opposed by the health insurance industry that would have arguably included utilization review. Also deemed approved was a rule permitting those enrolled in the District's Employee Benefits Program to enroll a domestic partner and children of the domestic partner under family coverage, provided the employee pays 25 percent of the premium.

NEW JERSEY Health Insurance : The legislature passed the state budget with supplementary legislation calling for a .35 percent premium tax increase on group accident and health insurance policies, and a 2 percent increase on surplus lines, effectively increasing the tax to 1.35 percent and 5 percent respectively. Both are a part of the state's overall $1 billion in tax increases for the new fiscal year and include a one-year sunset provision. An autism coverage mandate is on its way to Governor Corzine's desk for his signature. The Senate also gave final approval to legislation requiring installment payments for maternity services. This bill calls for the Department of Banking & Insurance to develop a mechanism to provide incremental payments for prenatal services. The immediate effective date was postponed for one year. The legislature is now in recess and is unlikely to return until after the November election.

NORTH CAROLINA Health Insurance : Discussion continues regarding the proposal to increase premium taxes across all lines of insurance from 1.9 percent to 2.25 percent effective January 1, 2011. Several trade organizations, including America's Health Insurance Plans and the North Carolina Association of Health Plans, are working on letters to key legislators in opposition to the tax. Aetna is also working on similar communications and is urging customers to get involved.

OHIO Health Insurance : Despite the June 30 deadline for passing the state's biennial budget, Governor Strickland and the General Assembly remain at a stalemate. The Senate President has rescheduled meetings of the joint conference committee several times as he and the governor spar over whether the decision to permit video terminals at racetracks should be legislated or put to a ballot vote. Faced with a $3.2 billion budget shortfall, allowing an expansion of gambling is projected to decrease the deficit by $933 million. In the meantime, Governor Strickland signed an interim seven-day budget that sets funding for a number of agencies at 30 percent less than they received in 2008. This is the first time in 18 years that Ohio has had an interim budget.

The House Civil and Commercial Law Committee passed a bill prohibiting a material amendment to a provider contract from becoming effective absent the affirmative consent of both parties. This was an expected result in the Democratically controlled House. Efforts to defeat the bill will be focused on the Senate.

OKLAHOMA Health Insurance : The following interim studies were recently approved to go forward by legislative leadership: a study concerning systematic health education in the schools, health care access for primary care in schools (Community School Initiative) and care coordination to facilitate access to health care in the community; a study regarding how the State of Oklahoma buys benefits for their employees and dependents (state-run versus private carriers and private TPA-run insurance programs and pension plans); a study regarding the subject of insurance companies rescinding and canceling citizens' health insurance policies for arbitrary reasons; and a study considering issues relating to interstate purchasing of health insurance policies.

OREGON Health Insurance : Governor Kulongoski signed comprehensive health care reform legislation this week that establishes a Health Policy Board to serve as the policy making and oversight body for the newly created Oregon Health Authority. The Board is charged with a number of duties including the development of a universal coverage proposal, quality and cost containment programs, premium assistance and a statewide Health Insurance Exchange. The Authority will take on the responsibility for the Exchange, including the development of rules and base-line benefit packages for the plans offered within the Exchange. The Authority will also develop uniform contracting standards and claim processing, a framework for rate filings, MCR standards, the use of medical homes, quality data reporting and dissemination and the use comparative effective research.

The Governor is also expected to sign a new funding mechanism that would institute a temporary 1 percent premium tax, higher hospital fees and assessments, new corporate tax rates to pay for the reform proposal and expand coverage for low-income families and children.

TEXAS Health Insurance : A "Special Session" called by Governor Rick Perry began July 1 and wrapped up on July 2. HB2, which will take the Texas Department of Insurance out of "wind down" mode and continue the agency's existence until it can be reviewed on a limited basis by the Sunset Commission during the 2011 legislative session, was passed by the House on July 2 and by the Senate on July 3. The legislature then quickly adjourned in time to enjoy the July 4 holiday. TDI will now immediately begin its review by the Sunset Commission.