By Cori H. Loomis and Laura Brookins*
March 27, 2009
The Oklahoma State Legislature convened its 2009 session on the first Monday in February. The following is a summary of the healthcare reform initiatives under consideration by the House and Senate.
HB 2026 creates the "Health Care for Oklahomans Act," which provides for the following:
- Directs the Oklahoma Health Care Authority (OHCA), in collaboration with the Department of Insurance (DOI), to establish the Health Care for the Uninsured Board (HUB). The HUB shall:
- Certify health plans that will be recommended by the HUB.
- Establish a system of counseling that includes educating consumers, aiding consumers in choosing policies, and educating consumers on how to utilize primary and preventative care.
- Establish a system whereby if an individual qualifies for a subsidy under the premium assistance program, that person is able to become enrolled through the HUB in conjunction with local, qualified agents.
- Directs the OHCA to initiate a program with Oklahoma hospitals and healthcare providers to initiate enrollment at point of service.
- Authorizes health plans to offer standard health benefit plans to individuals under forty years of age. These are plans that do not provide state-mandated health benefits, but that provide creditable coverage.
- Authorizes the OHCA to create, as part of the premium assistance program, an option to purchase a high-deductible health insurance plan that is compatible with a health savings account.
- Permits employers to take a tax credit of $500 per year for participating in a Section 125 plan, for tax years beginning after December 31, 2009. A "Section 125 plan" means a separate written plan maintained by an employer for employees that meets the specific requirements and regulations of Section 125 of the Internal Revenue Code.
- Permits the Offering of Mandate-Free Health Plans.
- Authorizes health plans to offer standard health benefit plans to individuals under age forty, accompanied by a policy with state-mandated health benefits.
- Directs the health plan to file for informational purposes the rates to be used for a standard health benefit plan with the DOI.
- "State-mandated health benefits" means coverage for healthcare services or benefits, required by state law or state regulations, requiring the reimbursement or utilization related to a specific illness, injury, or condition of the covered person, or inclusion of a specific category of licensed healthcare practitioner to be provided. It shall not include any healthcare services or benefits that are mandated by federal law.
- Establishes requirements for introduction of mandate legislation.
- Requires that any bill that mandates health coverage for specific benefits be introduced in odd-numbered years and passed in even-numbered years.
- Provides an exception in case of an unforeseen emergency.
- Requires organizations advocating a mandated benefit to submit a report to the respective house assessing the financial impact of the proposed coverage.
- Creates the Task Force on the Review of Health Insurance Mandates
- Creates a task force to review and evaluate the health insurance mandates that are currently provided for by law.
- Requires the Task Force to submit a report to the governor, House Speaker, and Senate President pro tempore by no later than December 1, 2010, with recommendations as to whether any existing mandates should be revised or eliminated.
- Modifies "Insure Oklahoma" eligibility.
- Clarifies "for-profit employer" is an entity that is not exempt from taxation pursuant to the provisions of Section 501(c)(3) of the Internal Revenue Code.
- Clarifies "not-for-profit employer" shall mean an entity that is exempt from taxation pursuant to the provisions of Section 501(c)(3) of the Internal Revenue Code.
- Includes foster parents that are employed by employers with more than 250 employees.
- Expands coverage to veterans who are not on active duty and who have not been dishonorably discharged who meet certain eligibility criteria.
- Proposes a constitutional amendment modifying appropriation limitations from the Tobacco Settlement Endowment Trust Fund.
- Would require a vote of the people.
- 90% on clinical and basic cancer research and tobacco related diseases, cost-effective tobacco prevention and cessation, programs to improve health, programs for children, programs for seniors, and now 10% on adult stem cell research.
*AHLA wishes to thank Cori H. Loomis, Esquire, and Laura Brookins, Esquire (Crowe & Dunlevy, Oklahoma City, OK) for writing this email alert.