April 11, 2008
Health Insurance Co-payment Bills Pass in House and Senate

H. 7507 Sub A -  which was passed by the House on 3/27/08, would require small employer health insurance carriers to reimburse hospitals for certain uncollected member co-payments and deductibles and would also place conditions upon the variation of adjusted community rates applied to small employer carriers.  A similar Senate bill - S. 2414, was passed in the Senate on 3/19/08 and has been referred to the House Corporations Committee. 

Lt. Gov. Roberts Hosting Community Meetings on the Healthy Rhode Island Reform Act of 2008

Several Health Care Reform Proposals Under Review in the RI General Assembly
 
A series of hearings have been convened over the past few weeks in the Rhode Island General Assembly at which RIBGH provided testimony concerning several health care reform proposals. See information below for a comprehensive list of Rhode Island House and Senate bills related to health care.

RIBGH has taken a position on the following bills:

H. 7352 and S. 2484  - Part I of the Healthy Rhode Island Reform Act of 2008 – which would establish the Healthy Rhode Island Strategic Plan and Chronic Care Management Program.  The bills are currently under review in the House and Senate, respectively.

 RIBGH Position:    RIBGH believes that addressing the problem of the uninsured in Rhode Island, improving health care quality and controlling costs requires the careful coordination of all stakeholders and a model that has built-in incentives to balance both quality and cost efficiencies.  In 2007, RIBGH members participated in the development of enacted legislation that established the health care planning and accountability advisory council.  H. 7352 and S. 2484 propose the utilization of this advisory council in the development of the Healthy Rhode Island Strategic Plan and Chronic Care Management Program for Rhode Island.

H. 7465 and S. 2481 – Part III of the Healthy Rhode Island Reform Act of 2008 – would create a health care quality and value (“all-payer”) database.  S. 2481 was heard by Senate Committee on 2/27/08 and is currently under review. 

 RIBGH Position:  RIBGH supports evidence-based medicine initiatives that rely on the employer, payer, and provider to collect data on outcomes to support the most effective forms of care and to encourage their use through refinement of the benefit design.  H. 7465 and S. 2481 would create the collection of such data needed for the development of evidence-based medicine.

H. 7910 and S. 2472 – Part IV of the Healthy Rhode Island Reform Act of 2008 - would create the Rhode Island Health Insurance Access Hub Act of 2008 to facilitate the purchase of affordable health care to eligible persons and groups.  H. 7910 was heard by the  House Corporations Committee on 3/11 is being held for further study..  S. 2472 was  heard by the Senate Health & Human Services Committee on 3/19 and is being held for further study.

RIBGH Position:  RIBGH supports the creation of the Rhode Island Health Hub, the equivalent of the Massachusetts “Connector.” 

S. 2686 –Part V of the Healthy Rhode Island Reform Act of 2008 – would establish an  individual mandate, which would institute a requirement for individuals above 400% of the Federal Poverty Level ($40,840 individual/$82,600 family of four) to purchase and maintain affordable health insurance coverage as of July 2009 or risk the loss of a personal income tax exemptionand employer “pay or play” proposal  (A similar bill – H. 7915 – was introduced through the Office of the Health Insurance Commissioner.  This bill was passed by the House Corporations Committee on 4/9/08 and has been placed on the House calendar for a vote. 

RIBGH Position:  RIBGH supports the individual mandate component of this bill.

RIBGH opposes the employer health security assessment component of the bill.    This component of S. 2686 would require employers (with more than 10 employees) to pay a “health security assessment” per employee (excludes employees with less than 90 days of employment or who normally work less than 30 hours per week and temporary employees hired for less than 5 months, seasonal employees, or employees with alternative group or non-group health insurance coverage not provided by the employer or who are enrolled in Medicare or participate in a government-sponsored medical assistance program).  The assessment would be equivalent to 8% of the taxable wage base, and employers would be able to deduct from the assessment owed for each employee an amount equal to their average expenses per employee for providing health insurance coverage or other health care benefits to employees.  The assessment would be utilized to subsidize the cost of providing affordable health insurance coverage to uninsured Rhode Islanders. 

 H. 7399  - Part VI of the Healthy Rhode Island Reform Act of 2008 – which would amend the definition of dependent on health insurance policies and would not require that a child between 19 and 25 be a student to be considered a dependent.  This bill was heard on 3/11/08 by the House Corporations Committee, who recommended this measure be held for further study.

RIBGH Position:  RIBGH opposes additional mandated benefits and has concerns that
this type of mandate could create ERISA problems for multi-state employers who need to be able to have a consistent benefits platform for all of their employees throughout the United States.  In addition, the potential tax implications for expanding coverage to dependents to age 25 (the “dependent” may not meet the I.R.S. definition of a “qualifying child”) could create an additional administrative burden for employers and an issue for employees who would have to deal with imputed income related to the cost of such dependent coverage. 

H. 7493 and S. 2286 - Part VII of the Healthy Rhode Island Reform Act of 2008 - would establish a regional health insurance market between Rhode Island, Massachusetts, and Connecticut to expand opportunities for regional insurers to offer insurance in Rhode Island.  H. 7493 was heard by the House Corporations Committee on 3/11/08 and is being held for further study.  S. 2286 was heard by the Senate Health & Human Services Committee on 3/5/08. 

RIBGH Position:  RIBGH supports this proposed legislation.

H. 7466 and S. 2222 – Part VIII of the Healthy Rhode Island Reform Act of 2008 – would create a joint nine-member legislative task force to study all aspects of health care reform relating to the Healthy Rhode Island Reform Act of 2008 with the purpose of making a comprehensive study of all aspects of health care reform and reporting back to the General Assembly no later than 6/4/09.  H. 7466 was passed by the House Health, Education and Welfare Committee on 4/9/08 and placed on the House calendar for a vote.  S. 2222 was passed by the Senate on 3/27/08 and has been referred to the House Health, Education and Welfare Committee.

RIBGH Position:  RIBGH supports this proposed legislation.

Rhode Island Health Information Exchange Act of 2008 -  H. 7409 and S. 2679, which would establish safeguards and confidentiality protection for health information exchange, was heard on 3/26/08 by the House Health, Education & Welfare Committee and the Senate Health & Human Services Committee, respectively, and both bills are being held for further study. 

 RIBGH Position:  RIBGH supports greater health care transparency, including proposals such as these to establish a statewide health information network and the ability for access to electronic medical records, which can improve patient outcomes and coordination of care and reduce duplication and inefficiencies in the system, all of which can significantly reduce health care costs for both purchasers and consumers. 

Health Insurance Premium Increase Cap – H. 7491 which would limit the percentage increase amount that certain contracts for health insurance would be allowed to increase annually and would take effect on 1/1/09, was heard by the House Corporations Committee on 3/11/08 and is being held for further study.

RIBGH Position:  RIBGH supports this proposed legislation.

Mandated Health Benefits Review – S. 2279 would create an independent committee to review the cost-effectiveness, medical efficacy and social need for mandated health insurance benefits and would take effect 1/1/09.  S. 2191 would require a mandated benefit review by the RI Health Insurance Commissioner on any mandated benefit introduced after 1/1/08 contingent on the review being paid for by the state health care providers.  A hearing on both of these bills was held on 2/13/08 by the Senate Health & Human Services Committee, who recommended the measures be held for further study

 RIBGH Position:  RIBGH supports this proposed legislation.

Funding for Coordinated Health Planning – S. 2466, introduced on 2/13/08 and referred to the Senate Finance Committee, would allocate matching funds of $250,000 for the continuation of the Coordinated Health Planning and Accountability Advisory Council from funds attached to the 2% annual tax on gross premiums on insurance contracts.  This bill has been referred to the Senate Finance Committee for hearing/consideration.

RIBGH Position:  RIBGH supports this proposed legislation.

Fair Share Health Care Fund (H. 7181) –  would establish the Fair Share Health Care Report and would require employers of 1,000 employees or more to file annual reports relating to the portion of total employees’ health care costs paid by the employer.  This bill was scheduled for hearing on 2/12/08 by the House Labor Committee and continued.

RIBGH Position:  RIBGH opposes this proposed legislation.

Mandated Health Benefits Proposals  

Infertility Coverage - H. 7239 and S. 2285 would provide insurance coverage for treatment of infertility for unmarried, as well as married, persons.  Both bills are being held for further study by the House Corporations and the Senate Health & Human Services Committees, respectively.

Acupuncture Coverage – S. 2161 would mandate acupuncture coverage in health insurance policies and has been referred to the Senate Health & Human Services Committee for review.

Cochlear Implant Coverage – H. 7436 would require insurance coverage for the cochlear implant surgery.  This bill was heard by the House Health, Education & Welfare Committee on 3/19/08 and is being held for further study.

RIBGH Position:  RIBGH opposes these bills.