SB 243 - This act establishes the Missouri Universal Health Assurance Program (Program), which is a publicly-financed, statewide insurance program that will provide comprehensive health care coverage for Missouri residents. This act has a conditional effective date and the act will be submitted to the voters of the state for approval or rejection in November, 2000.

The Director of the Department of Health will divide the population of the state into six regional districts, with an advisory council established for each district.

The Program will be administered by a nineteen member Board of Governors, ten of which will be appointed by the Governor, with the advice and consent of the Senate. Members will include the directors of the Departments of Social Services, Health, and Mental Health. Members shall include a sufficient representation of minority and disabled individuals. The Board is responsible for implementing the Program, monitoring expenditures, adopting rules, employing staff, and studying the means of incorporating institutional long-term care benefits into the Program. An annual report will be required after conducting investigations and utilization reviews.

An annual comprehensive state health care plan should be established by the Board and should include a budget, an evaluation of district health care needs, and goals for various parts of the Program. Prior to establishment, the Board should appoint advisory subcommittees of health care research and ethics experts and public hearings should be held. The resulting comprehensive health care plan should seek to secure the most cost-effective health care.

The Board should establish the "Missouri Health Care Trust Fund" which will be used for all aspects of Program operation. Revenues held in the trust fund are not subject to appropriation or allotment by the State or any political subdivision of the State. Various accounts will be created within the trust fund for specific purposes.

Every person who is a resident of Missouri, regardless of preexisting conditions, will be eligible to receive benefits for covered services under the Program. Persons who are not residents, but who are employed in Missouri will be eligible for benefits if a health premium surcharge is paid. Certain services, as listed, will not be covered under this Program. Other insurers and employers may offer benefits that do not duplicate those offered by the Program.

Every employer or self-employed person within the State will pay a health premium surcharge to the Department of Revenue based on the number of employees it has. A health premium surcharge, in addition to the state income tax, will be imposed on residents' gross income. An employer may agree to pay all or part of an employee's surcharge. For five consecutive tax years after approval of the Program, any employer who has twenty-five or less employees will be allowed a tax credit against the new tax due in incremental amounts.
ERIN MOTLEY