Bill 689

                    Current Status

Bill Number:               689
Ratification Number:       561
Act Number                 614
Introducing Body:          Senate
Subject:                   Health Benefit Demonstration Project,
                           Health Benefit Plan Demonstration
                           Council

(A614, R561, S689)

A JOINT RESOLUTION TO CREATE THE HEALTH BENEFIT PLAN DEMONSTRATION PROJECT TO DEVELOP AND TEST MODELS FOR PROVIDING HEALTH INSURANCE COVERAGE TO SOUTH CAROLINIANS WHO CURRENTLY ARE UNINSURED; CREATE THE HEALTH BENEFIT PLAN DEMONSTRATION COUNCIL AND PROVIDE FOR IT TO ASSIST AND ADVISE THE HEALTH AND HUMAN SERVICES FINANCE COMMISSION ON THE PROJECT; PROVIDE FOR THE POWERS AND DUTIES OF THE COMMISSION; EXEMPT THE PROJECT FROM CODE PROVISIONS AND REGULATIONS RELATING TO INSURANCE AND FUNDING; AND PROVIDE FOR THE PROJECT'S TERMINATION.

Whereas, it is the policy of South Carolina to protect and promote the health of the public and to assist its citizens in obtaining access to health care; and

Whereas, the cost of health care as well as private health insurance is rising in South Carolina, thereby limiting access to health care for many citizens; and

Whereas, private health insurance is unaffordable to many individuals and employers; the high cost of insurance prohibits some employers from offering this benefit while others are forced to discontinue or reduce coverage; and

Whereas, in South Carolina, approximately two hundred thousand people forego medical care because they cannot afford to pay for it; and

Whereas, there are approximately three hundred fifty thousand people who receive health care services but, because they are unable to pay for all or part of these services, their health care expenses are not paid; and

Whereas, when health services are rendered and not paid, many of these expenses are shifted to the cost of services for which there is payment; and

Whereas, if health insurance were available to more individuals the need to cost shift should be reduced; and

Whereas, on any given day in South Carolina there are approximately four hundred fifty thousand people without either public or private health insurance; and

Whereas, approximately one-half of the uninsured in South Carolina are employed full-time but often health insurance is not offered by their employers and they are unable to afford private coverage; and

Whereas, eighty percent of new jobs in South Carolina are created by small businesses which generally have to pay ten percent to forty percent higher premiums; affordable health insurance would promote a climate in which more of these businesses could thrive; and

Whereas, available health care coverage for entry level employees would remove a barrier to employment for many persons receiving public assistance since Medicaid would be replaced by employer-based insurance; and

Whereas, health care costs may be more equitably distributed and more citizens of South Carolina would have access to health care if health insurance were more affordable; and

Whereas, it is in the best interest of the people and State of South Carolina to encourage the gainful employment of citizens of this State in the private enterprise economy, and thereby decrease the number of individuals and families wholly or partially dependent upon public assistance; and

Whereas, the General Assembly finds that in order to establish policies and programs to help provide affordable, equitable, and accessible health insurance coverage it would benefit from the experience of demonstration projects to test means by which this could be accomplished. Now, therefore,

Be it enacted by the General Assembly of the State of South Carolina:

Health Benefit Demonstration Project, Health Benefit Plan Demonstration Council

SECTION 1. There is created the Health Benefit Plan Demonstration Project. The purpose of this project is to develop and test models for providing health insurance coverage to South Carolinians who are currently uninsured with an emphasis on the working uninsured. Three test sites may be selected for the demonstration project and program models, and these demonstration projects and program models should have the potential for replication elsewhere in the State or on a statewide basis.

This project must be developed, implemented, and administered by the South Carolina Health and Human Services Finance Commission. An eighteen-member Health Benefit Plan Demonstration Council comprised of the following members shall assist and advise the commission throughout the duration of this project:

(1) the Executive Director of the South Carolina Health and Human Services Finance Commission who shall serve as chairman of the council;

(2) the Director, or his designee, of the Governor's Division of Health and Human Services;

(3) the Executive Director, or his designee, of the South Carolina Primary Care Association;

(4) the Executive Director, or his designee, of the South Carolina Development Board;

(5) the Commissioner, or his designee, of the South Carolina Department of Health and Environmental Control;

(6) the Commissioner, or his designee, of the South Carolina Department of Insurance;

(7) the Commissioner, or his designee, of the South Carolina Department of Social Services;

(8) the Executive Director, or his designee, of the South Carolina Hospital Association;

(9) the Executive Director, or his designee, of the South Carolina Medical Association;

(10) the Executive Director, or his designee, of the South Carolina Chamber of Commerce;

(11) the Executive Director, or his designee, of the South Carolina Association of Counties;

(12) a South Carolina representative of the National Federation of Independent Business;

(13) two members appointed by the Chairman of the House Medical, Military, Public and Municipal Affairs Committee;

(14) two members appointed by the Chairman of the Senate Medical Affairs Committee;

(15) one member appointed by the Chairman of the House Ways and Means Committee; and

(16) one member appointed by the Chairman of the Senate Finance Committee.

The chairman of the council shall seek advice and expertise from other public and private sources to assist in the development and implementation of the demonstration project.

Finance Commission powers and duties

SECTION 2. The powers and duties of the Finance Commission in carrying out the responsibilities of this act include, but are not limited to:

(a) contracting for services to carry out the provisions of this act and to achieve the purpose of this project;

(b) establishing criteria for demonstration project models;

(c) selecting demonstration sponsors and sites;

(d) approving demonstration site benefit plans;

(e) soliciting public and/or private resources for use by the demonstration project;

(f) reporting semiannually on the progress and status of the demonstration project to the Senate Medical Affairs Committee, the House Medical, Military, Public and Municipal Affairs Committee, and the Joint Insurance Study Committee; and

(g) making a final report and recommendations to the General Assembly.

Exemption

SECTION 3. The Health Benefit Plan Demonstration Project is exempt from the provisions of Title 38 of the 1976 Code and regulations promulgated by the Chief Insurance Commissioner.

Funding

SECTION 4. The General Assembly annually may provide for the funding of the demonstration project in the state general appropriations act. In addition to state funds, funds from private sources may be secured, and the model programs tested by the project must generate funds from employers and employees participating in the program to be utilized in securing the health insurance offered through the program. The commission shall endeavor to achieve a ratio of state appropriated funds to other funds at least equivalent to, if not greater than, the state Medicaid match.

Termination

SECTION 5. The Health Benefit Demonstration Project terminates three years from the effective date of this act unless otherwise reauthorized by the General Assembly.

Time effective

SECTION 6. This act takes effect upon approval by the Governor.

Became law without the signature of the Governor.

Effective May 15, 1990.