House Amendment 1324
PAG LIN
1 1 Amend Senate File 389, as amended, passed, and
1 2 reprinted by the Senate, as follows:
1 3 #1. By striking page 1, line 2, through page 20,
1 4 line 27, and inserting the following:
1 5 <IOWA CHOICE HEALTH CARE COVERAGE COUNCIL
1 6 Section 1. Section 514E.1, subsections 15 and 22,
1 7 Code 2009, are amended to read as follows:
1 8 15. "Iowa choice health care coverage advisory
1 9 council" or "advisory council" "council" means the
1 10 advisory council created in section 514E.6.
1 11 22. "Qualified health care coverage" means
1 12 creditable coverage which meets minimum standards of
1 13 quality and affordability as determined by the
1 14 association by rule.
1 15 Sec. 2. Section 514E.2, subsection 3, unnumbered
1 16 paragraph 1, Code 2009, is amended to read as follows:
1 17 The association shall submit to the commissioner a
1 18 plan of operation for the association and any
1 19 amendments necessary or suitable to assure the fair,
1 20 reasonable, and equitable administration of the
1 21 association. The plan of operation shall include
1 22 provisions for the development of a comprehensive
1 23 health care coverage plan as provided in section
1 24 514E.5. In developing the comprehensive plan the
1 25 association shall give deference to the
1 26 recommendations made by the advisory council as
1 27 provided in section 514E.6, subsection 1. The
1 28 association shall approve or disapprove but shall not
1 29 modify recommendations made by the advisory council.
1 30 Recommendations that are approved shall be included in
1 31 the plan of operation submitted to the commissioner.
1 32 Recommendations that are disapproved shall be
1 33 submitted to the commissioner with reasons for the
1 34 disapproval. The plan of operation becomes effective
1 35 upon approval in writing by the commissioner prior to
1 36 the date on which the coverage under this chapter must
1 37 be made available. After notice and hearing, the
1 38 commissioner shall approve the plan of operation if
1 39 the plan is determined to be suitable to assure the
1 40 fair, reasonable, and equitable administration of the
1 41 association, and provides for the sharing of
1 42 association losses, if any, on an equitable and
1 43 proportionate basis among the member carriers. If the
1 44 association fails to submit a suitable plan of
1 45 operation within one hundred eighty days after the
1 46 appointment of the board of directors, or if at any
1 47 later time the association fails to submit suitable
1 48 amendments to the plan, the commissioner shall adopt,
1 49 pursuant to chapter 17A, rules necessary to implement
1 50 this section. The rules shall continue in force until
2 1 modified by the commissioner or superseded by a plan
2 2 submitted by the association and approved by the
2 3 commissioner. In addition to other requirements, the
2 4 plan of operation shall provide for all of the
2 5 following:
2 6 Sec. 3. Section 514E.5, Code 2009, is amended by
2 7 striking the section and inserting in lieu thereof the
2 8 following:
2 9 514E.5 IOWA HEALTH CARE COVERAGE PLANS == COVERAGE
2 10 OF ALL CHILDREN == STUDY AND RECOMMENDATIONS REGARDING
2 11 COMPREHENSIVE COVERAGE.
2 12 1. The Iowa choice health care coverage council,
2 13 in collaboration with the Iowa Medicaid enterprise and
2 14 the hawk=i board, shall consider options and make
2 15 recommendations for a comprehensive health care
2 16 coverage plan to provide health care coverage to all
2 17 children without such coverage, that utilizes,
2 18 modifies, and enhances existing public programs,
2 19 including the medical assistance program and hawk=i
2 20 program and maximizes the ability of the state to
2 21 obtain federal funding and reimbursement for such
2 22 programs.
2 23 a. The council shall consider options and make
2 24 recommendations for the coordination of a children's
2 25 health care network in the state that acts as a
2 26 resource for consumers to transition seamlessly among
2 27 public and private health care coverage options,
2 28 including but not limited to medical assistance,
2 29 hawk=i, and Iowa choice programs.
2 30 b. The council shall also consider options and
2 31 make recommendations for providing access to private,
2 32 unsubsidized, affordable, qualified health care
2 33 coverage to children who are not otherwise eligible
2 34 for health care coverage through public programs.
2 35 2. The council shall consider options and make
2 36 recommendations for providing access to private,
2 37 unsubsidized, affordable, qualified health care
2 38 coverage to all Iowa children less than nineteen years
2 39 of age with a family income that is more than three
2 40 hundred percent of the federal poverty level and to
2 41 adults and families with a family income that is up to
2 42 four hundred percent of the federal poverty level who
2 43 are not otherwise eligible for health care coverage
2 44 through public programs.
2 45 a. The council shall consider options and make
2 46 recommendations concerning what constitutes qualified
2 47 health care coverage for adults and families who are
2 48 not eligible for a public program.
2 49 b. The council shall consider options and make
2 50 recommendations for a health care coverage program
3 1 called Iowa choice which offers private qualified
3 2 health care coverage with options to purchase at least
3 3 three levels of benefits including a gold plan which
3 4 offers a comprehensive benefits package, a silver plan
3 5 which offers a medium benefits package, and a bronze
3 6 plan which offers a basic benefits package. The
3 7 council shall consider options and make
3 8 recommendations for providing an array of benefits
3 9 through the Iowa choice program that may include
3 10 physical, mental, and dental health care coverages.
3 11 3. The council shall also consider options and
3 12 make recommendations to offer a program to provide
3 13 coverage under the state health or medical group
3 14 insurance plan to nonstate public employees, including
3 15 employees of counties, cities, schools, area education
3 16 agencies, and community colleges, and employees of
3 17 nonprofit employers and small employers and to pool
3 18 such employees with the state plan.
3 19 4. The council shall study the ramifications of
3 20 requiring each employer in the state with more than
3 21 ten employees to adopt and maintain a cafeteria plan
3 22 that satisfies section 125 of the Internal Revenue
3 23 Code of 1986.
3 24 5. As part of considering options and making
3 25 recommendations for a comprehensive health care
3 26 coverage plan, the council may collaborate with health
3 27 insurance carriers to do including but not limited to
3 28 the following:
3 29 a. Design solutions to issues relating to
3 30 guaranteed issuance of insurance, preexisting
3 31 condition exclusions, portability, and allowable
3 32 pooling and rating classifications.
3 33 b. Formulate principles that ensure fair and
3 34 appropriate practices relating to issues involving
3 35 individual health care policies such as recision and
3 36 preexisting condition clauses, and that provide for a
3 37 binding third=party review process to resolve disputes
3 38 related to such issues.
3 39 c. Design affordable, portable health care
3 40 coverage options for low=income children, adults, and
3 41 families.
3 42 d. Design a proposed premium schedule for health
3 43 care coverage options that are recommended by the
3 44 council which includes the development of rating
3 45 factors that are consistent with market conditions.
3 46 e. Design protocols to limit the transfer from
3 47 employer=sponsored or other private health care
3 48 coverage to state=developed health care coverage
3 49 plans.
3 50 6. The council shall submit a report of its
4 1 recommendations for a comprehensive health care
4 2 coverage plan to the commissioner for review and
4 3 comment and the commissioner shall forward the report
4 4 and such comments to the general assembly no later
4 5 than February 15, 2010. The comprehensive health care
4 6 coverage plan shall become effective only upon
4 7 approval by the general assembly.
4 8 Sec. 4. Section 514E.6, Code 2009, is amended to
4 9 read as follows:
4 10 514E.6 IOWA CHOICE HEALTH CARE COVERAGE ADVISORY
4 11 COUNCIL.
4 12 1. The Iowa choice health care coverage advisory
4 13 council is created for the purpose of assisting the
4 14 association with developing considering the
4 15 recommending options to develop a comprehensive health
4 16 care coverage plan as provided in section 514E.5. The
4 17 advisory council shall consider options and make
4 18 recommendations concerning the design and
4 19 implementation of the comprehensive plan including but
4 20 not limited to a definition of what constitutes
4 21 qualified health care coverage, suggestions for the
4 22 design of health care coverage options, and
4 23 implementation of a health care coverage reporting
4 24 requirement.
4 25 2. The advisory council consists of the following
4 26 persons who are voting members unless otherwise
4 27 provided:
4 28 a. The two most recent former governors, or if one
4 29 or both of them are unable or unwilling to serve, a
4 30 person or persons appointed by the governor.
4 31 b. Seven members appointed by the director of
4 32 public health:
4 33 (1) A representative of the federation of Iowa
4 34 insurers.
4 35 (2) A health economist who resides in Iowa.
4 36 (3) Two consumers, one of whom shall be a
4 37 representative of a children's advocacy organization
4 38 and one of whom shall be a member of a minority.
4 39 (4) A representative of organized labor.
4 40 (5) A representative of an organization of
4 41 employers.
4 42 (6) A representative of the Iowa association of
4 43 health underwriters.
4 44 c. The following members shall be ex officio,
4 45 nonvoting members of the council:
4 46 (1) The commissioner of insurance, or a designee.
4 47 (2) The director of human services, or a designee.
4 48 (3) The director of public health, or a designee.
4 49 (4) Four members of the general assembly, one
4 50 appointed by the speaker of the house of
5 1 representatives, one appointed by the minority leader
5 2 of the house of representatives, one appointed by the
5 3 majority leader of the senate, and one appointed by
5 4 the minority leader of the senate.
5 5 3. The members of the council appointed by the
5 6 director of public health shall be appointed for terms
5 7 of six years beginning and ending as provided in
5 8 section 69.19. Such a member of the board is eligible
5 9 for reappointment. The director shall fill a vacancy
5 10 for the remainder of the unexpired term.
5 11 4. The members of the council shall annually elect
5 12 one voting member as chairperson and one as vice
5 13 chairperson. Meetings of the council shall be held at
5 14 the call of the chairperson or at the request of a
5 15 majority of the council's members.
5 16 5. The members of the council shall not receive
5 17 compensation for the performance of their duties as
5 18 members but each member shall be paid necessary
5 19 expenses while engaged in the performance of duties of
5 20 the council. Any legislative member shall be paid the
5 21 per diem and expenses specified in section 2.10.
5 22 6. The members of the council are subject to and
5 23 are officials within the meaning of chapter 68B.>
5 24 #2. Page 21, line 18, by striking the word <In>
5 25 and inserting the following: <9. In>.
5 26 #3. Page 21, lines 18 and 19, by striking the
5 27 words and figures <subsections 1 through 7> and
5 28 inserting the following: <subsections 1 through 7
5 29 this section>.
5 30 #4. Page 26, by inserting after line 23 the
5 31 following:
5 32 <Sec. . Section 249A.3, subsection 14, Code
5 33 2009, is amended to read as follows:
5 34 14. Once initial ongoing eligibility for the
5 35 family medical assistance program=related medical
5 36 assistance is determined for a child described under
5 37 subsection 1, paragraph "b", "f", "g", "j", "k", "l",
5 38 or "n" or under subsection 2, paragraph "e", "f", or
5 39 "h" the age of nineteen, the department shall provide
5 40 continuous eligibility for a period of up to twelve
5 41 months regardless of changes in family circumstances,
5 42 until the child's next annual review of eligibility
5 43 under the medical assistance program, if the child
5 44 would otherwise be determined ineligible due to excess
5 45 countable income but otherwise remains eligible with
5 46 the exception of the following children:
5 47 a. A newborn child of a medical
5 48 assistance=eligible woman.
5 49 b. A child whose eligibility was determined under
5 50 the medically needy program.
6 1 c. A child who is eligible under a state=only
6 2 funded program.
6 3 d. A child who is no longer an Iowa resident.
6 4 e. A child who is incarcerated in a jail or other
6 5 correctional institution.>
6 6 #5. Page 30, line 13, by striking the word
6 7 <prior>.
6 8 #6. Page 31, by striking line 11 and inserting the
6 9 following: <amounts, and graduated premiums based on
6 10 a rationally developed sliding fee schedule, in
6 11 accordance with federal>.
6 12 #7. Page 35, by inserting after line 28 the
6 13 following:
6 14 <Sec. . EFFECTIVE DATE == RETROACTIVE
6 15 APPLICABILITY. The section of this division of this
6 16 Act amending section 249A.3, subsection 14, being
6 17 deemed of immediate importance, takes effect upon
6 18 enactment and is retroactively applicable to July 1,
6 19 2008.>
6 20 #8. Page 42, by striking lines 16 and 17 and
6 21 inserting the following: <interest or earnings on
6 22 moneys deposited in the fund or in the accounts within
6 23 the fund shall be credited to the fund or the accounts
6 24 within the fund, as applicable.>
6 25 #9. Page 44, line 17, by striking the words <and
6 26 a> and inserting the following: <and any>.
6 27 #10. Page 44, line 23, by striking the word
6 28 <purposes> and inserting the following: <purpose>.
6 29 #11. By striking page 53, line 23, through page
6 30 67, line 33, and inserting the following:
6 31 <DIVISION
6 32 HEALTH CARE TRANSPARENCY>
6 33 #12. By striking page 68, line 14, through page
6 34 69, line 20.
6 35 #13. Title page, line 2, by striking the words
6 36 <providing penalties,>.
6 37 #14. By renumbering as necessary.
6 38
6 39
6 40
6 41 COMMITTEE ON HUMAN RESOURCES
6 42 SMITH of Marshall, Chairperson
6 43 SF 389.711 83
6 44 av:pf/rj/22592
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