ࡱ> vxu j(bjbj I64 5. . qqqqq8$7(QQQ?7A7A7A7A7A7A7T9;JA7qQQA7qq4V7pqq6?7/1 XFC1:6l707}1l@<@<H11@<q 2|Q lQQQA7A7P|QQQ7@<QQQQQQQQQ. 7:   WASHINGTON ASSOCIATION OF HEALTH UNDERWRITERS LEGISLATIVE UPDATE April 1, 2009 House and Senate Budget Proposals to be Released Legislative leaders in the House and Senate have indicated that the Senate will likely release its budget proposal for the 2009-2011 biennium on Monday, March 30. The House will release its plan one day later. Budget writers have stated that the new spending plan will reduce budgets in many priority areas like health care, general assistance, and education. With a budget shortfall approaching $9 billion, there is an active debate within the House and Senate Democratic caucuses about new tax proposals. The details have not yet been released, but speculation is growing that the budget plan may be accompanied by a proposal to increase taxes. Business groups argue that taxes should not be increased while the states economy continues in recession. Any tax plan would likely be submitted to the voters. Current public opinion surveys suggest that significant tax increases will likely be a tough sell with the voters. House Committee Approves Scaled-back Reform Proposal The House Health Care & Wellness Committee has approved an amended version of 2SSB 5945a bill that was introduced by Senator Karen Keiser to provide universal coverage to all Washington residents by 2012. The measure was previously amended and approved by the Senate to establish a Washington Health Partnership as a working group to focus on health care reform goals in phases. These phases include extending coverage to individuals below 200% of the federal poverty level in an Apple Health program for adults, consolidating the purchase of health coverage, and streamlining administration. The Partnership would also examine health care reform proposals. Under the measure passed by the Senate, the Partnership would be required to seek to maximize federal funds for vaccines for low income children and family planning services. The bill also calls for the Partnership to determine if additional federal funds are available to provide funding for vaccines for non-Medicaid eligible children under 300% of the federal poverty level. The amended bill carries a fiscal note of nearly $625,000 for the next biennium. Business groups expressed opposition to the measure, arguing that the Medicaid provisions in the measure would commit the state to future financial obligations even if the additional federal funding becomes unavailable, and that the proposal contemplates billions of dollars in new payroll taxes if it becomes fully implemented. The bill will be referred to the House Ways and Means Committee for consideration of it impact on the state budget. House Committee Amends Controversial Bill on Retainer Medicine Plans The House Health & Wellness Committee has substantially amended SSB 5436a measure that would allow retainer medicine plans to expand services that are currently allowed. Under the Senate-passed bill, direct practices furnishing primary care would be allowed to pay for charges associated with routine lab and imaging services. As passed by the Senate, the bill would also partially lift restrictions on direct practices from accepting payments for services from insurers, and would allow direct practices to accept payments from self-insured plans and employers. Under the amendment adopted by the House committee, however, the current restrictions prohibiting retainer practices from accepting payments from insurers and employers is maintained. The amendment also allows retainer practices to be considered for participation in primary care medical home reimbursement pilot projects. AHIP and other health plan representatives testified in opposition to the measurearguing that the bill prematurely expands the authority of retainer practice plans before the first report from the OIC is due, and that such plans are not required to comply with a wide array of regulatory requirements that are imposed on health carriers. House Committee Approves OIC Bill to Regulate Discount Plans A proposal introduced at the request of Insurance Commissioner Mike Kreidler to regulate certain Discount Health Plans has been approved by the House Health Care & Wellness Committee. The measure has already been passed by the Senate. SSB 5480 would establish consumer protection standards and new regulatory requirements with respect to health programs that market discounts on charges for health care services. The measure would require such programs to be licensed by the OIC before conducting business in the state, and current programs would have six months from the effective date of the act to submit an application and come into compliance. The hearing on the measure, the OIC testified in support, indicating that consumers are frequently confused by marketing materials relating to discount programs, and that his office does not currently have regulatory authority over them. The Washington Association of Health Underwriters also testified in support of the bill, arguing that licensed agents and brokers must adhere to regulatory standards with respect to their actions, but that those who market discount programs are not subject to any standards or requirements, and that consumers can easily become confused about what is being sold. The bill will likely go to the House Ways and Means Committee for consideration. Senate and House Prepare to Consider Measures Relating to the Individual Market Standard Health Questionnaire The full Senate may soon consider ESHB 1401, and the House may soon take up ESSB 5406companion measures that would allow individuals who are eligible to purchase COBRA coverage, or who drop COBRA coverage, to be exempt from the standard health questionnaire when they apply for individual health insurance coverage. There was no testimony in opposition to either measure when they were considered at hearing, and they were quickly brought to a vote and approved. ESHB 1401 has been pulled from the Senate Rules Committee and placed on the Senate floor calendar. ESSB 5406 remains in the House Rules Committee, but could be brought to the floor for consideration at any time. Study on Association Health Plans Likely to Appear in Budget Proviso Although the House killed SHB 1714a controversial measure relating to association group plansit appears increasingly likely that the issue may be addressed in a budget proviso later this session. SHB 1714 was killed when it was not brought to a vote on the House floor prior to the cut-off for approval on Thursday, March 12. The measure was the subject of significant negotiations between business groups, the OIC, and key legislators. The issue may remain alive, however, as key legislators are now suggesting that the budget may include language calling for data on association health plans to be provided to the Office of the Insurance Commissioner to facilitate a better understanding of the association health plan market. Association groups have been negotiating the language of a possible budget proviso with the Office of the Insurance Commissioner and key legislators. House Committee Approves Bill on Administrative Simplification and Streamlining The House Health Care & Wellness Committee has approved 2SSB 5346a measure that is intended to establish streamlined and uniform standards for the administration of private and public health care programs. The Forum, together with the Washington State Medical Association and AARP testified in support of the measure. AHIP urged the committee to continue to include state programs within the requirements of the measure. The bill directs the Insurance Commissioner to designate one or more lead organizations to coordinate the development of processes, guidelines, and standards to streamline health care administration for use by payers and providers of health care services in Washington State. The bill also directs the Department of Social and Health Services, the Department of Labor and Industries, and the Health Care Authority to cooperate in this process. The bill will go to the House Ways and Means Committee for consideration of a $1.4 million fiscal note.     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