ࡱ> uwv #bjbj I.5. . qqqqq86t(III6666666S8:J6qII6qq46qq56. 1 \df0:56060l?;|?;H11?;q,1Ir[\NIII66yvIII6?;IIIIIIIII. 7:   WASHINGTON ASSOCIATION OF HEALTH UNDERWRITERS LEGISLATIVE UPDATE April 20, 2009 House Committee Considers Bill to Increase State Sales TaxesBusiness Groups Voice Opposition The House Health & Human Services Appropriations Committee held a hearing on Friday, April 17 to consider HB 2377a measure that was introduced only one day before the hearing, and which would increase the state sales tax by .3 percent with the new revenue dedicated to various health care programs. The measure provides that the increase would terminate on December 31, 2012. Importantly, the measure contains a referendum clause, directing that the increase would only become effective if approved by the voters. Last week House Speaker Frank Chopp indicated that there is a better than 50/50 chance that an increase in sales taxes will be submitted to the voters. The state sales tax is currently 6.5%, so the additional .3% allowed under the bill would result in a state sales tax rate of 6.8%. Cities and counties impose additional local option sales taxes, and in many areas the combined sales tax would reach just under 10%. A sales tax increase is likely to be a tough sell with the voters, however. Current surveys continue to show a majority of voters opposed to an increase in sales taxes. The measure will likely move forward only if proponents provide public opinion research suggesting that voters can be persuaded to approve it. House Approves Scaled-back Reform Proposal A scaled-back version of 2SSB 5945 has been approved by the House, and the amended measure will now be returned to the Senate for consideration of the House amendments. The bill was originally 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. Under the Senate-passed version of the bill, these phases included 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. Under the measure passed by the Senate, the Partnership would also review various reform proposals and seek to maximize federal funds for vaccines for low income children and family planning services. The Senate-passed 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. Business groups expressed opposition to the measure in the House, 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 House Health & Human Services Appropriations Committee adopted a striking amendment for the measure, however, significantly scaling it back even further. The amendment outlines various general principles for reform, and establishes a new advisory group to provide review progress and make recommendations with respect to these principles. The amendment also requires the Department of Social and Health Services to seek expanded Medicaid funding from the federal government to the fullest extent possible, and to seek whatever federal funding may be available to provide premium assistance for eligible individuals to participate in employer-sponsored coverage. It is unclear whether the Senate will concur in the House amendments or insist on its position. House Kills Measure Regarding School Districts and ESDs Obtaining Health Coverage Programs Offered by the PEBB The House has killed SB 5491a measure that was originally introduced to require school districts and ESDs to obtain health coverage exclusively through the Public Employees Benefits Board. The bill was amended in the Senate with language calling for a study of the issue, but the WEA, together with school districts, WAHU and others continued to oppose the measure. The measure was killed when it was not brought to the House floor for a vote prior to the deadline at 5:00 on Friday. Barring some unusual development, the bill is dead for this year. House Approves OIC Bill to Regulate Discount PlansBill Goes to Governor Gregoire for Consideration A proposal introduced at the request of Insurance Commissioner Mike Kreidler to regulate certain Discount Health Plans has been approved by the full House floor on a final vote of 69-29. The measure has already been passed by the Senate, and has now been sent to Governor Gregoire for consideration. 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. House Approves Bill on Administrative Simplification and Streamlining The House 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 measure has already been approved by the Senate, but must be returned to the Senate for consideration of amendments adopted in the House. The Forum, together with the Washington State Medical Association and AARP testified in support of the measure. At hearings in the Senate and before the House Health Care & Wellness Committee, 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. Most observers expect the Senate to concur in the House amendments and send the bill to Governor Gregoire.     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