Author: Erin Boeckman
Date: 09/02/2010
The Oklahoma State and Education Employees Group Insurance Board, which manages the state's HealthChoice plans, and the Oklahoma Employees Benefits Council, which contracts with health maintenance organization providers, on Wednesday approved revised rates for the 2011 calendar year. According to information from EBC, HMO rates will increase an average of 6.7 percent, while rates for the HealthChoice High Option plan, OSEEGIB's most popular plan, will increase 1.51 percent.
Trish Frasier, policy and research director for OPEA, said that the association was pleased with the lower rates as well as the reduced copay approved by OSEEGIB. Included in the HealthChoice plan adjustments was a reduction in the copay for primary care office visits from $50 to $30 as well as no copay for preventative service visits for dependents.
"We are very pleased with lowering the copay for primary care providers," Frasier said. "We think it will make things easier for state employees."
OEA was also pleased that OSEEGIB and EBC approved lower plan rates, said Joel Robison, associate executive director and chief lobbyist for the association.
"We believe it was good for our education employees that the premiums were reduced," he said. The new rates will also provide some relief to education employees who carry their spouses and children on their health plans, he added.
However, both Robison and Frasier said that changes need to be made to how insurance is provided to education and state employees.
Earlier developments have already created a gap in the amount state employees receive via a benefit allowance to purchase insurance. Aetna chose to no longer contract with EBC to provide coverage. The loss of one of the highest premium plans decreased the calculation for the benefit allowance, which meant state employees lost money, Frasier said. She explained that because state employees have not received a pay raise since 2006, some employees purchase a less expensive insurance option and use the remaining funds from the benefit allowance to get by.
EBC already announced that the overall benefit allowance for state employees will be 0.81 percent lower than the current plan year.
Health care access for the state's rural employees also remains a concern for OPEA, Frasier said. The loss of Aetna as a provider contributed to that issue.
To address these issues, OPEA members at their recent annual convention pledged to preserve the benefit allowance for state employees and to provide choice to rural areas, Frasier said.
During the 2010 legislative session, OPEA supported legislation that could have reformed the state health insurance process and helped rural employees, Frasier said, but the proposal was vetoed by the governor.
In June, Gov. Brad Henry vetoed SB 2052, by Sen. Glenn Coffee, R-Oklahoma City, and Rep. Chris Benge, R-Tulsa, which would have created the Oklahoma Health and Wellness Board. The board would have been responsible for choosing one HMO to provide health insurance coverage to state employees. It also would have prohibited the current benefit allowance from dropping below plan year 2010 amounts, specifying that the benefit allowance be indexed on the basic preferred provider organization health benefit plan available. The bill also provided that any excess benefit allowance for new state employees hired after Nov. 1, 21010, be deposited in a health savings account, a flexible savings account or deferred compensation account.
Under the current system, HMOs pick their coverage areas based on where they can be profitable, Frasier said. Contracting with one HMO would have required coverage for the entire state, which would have provided options for rural state employees, she said.
According to a previous OPEA news release, SB 2052 would have resulted in lowering the cost of HMOs and offered rural employees the same options provided to urban employees.
In its efforts to reform the state's insurance system, Robison said that OEA will continue to pursue expanding coverage to include education employees' spouses and children.
Unlike other state employees, school employees are required to pay the full premium for any dependents on their plans, he explained. OEA has had a long-term legislative goal of achieving some kind of family and dependent coverage for education employees, and the association will continue to work toward that goal, he said.
Furthermore, OEA is a strong supporter of State Question 744, which would require Oklahoma each year to provide an amount of money to education that is equal to the amount spent per pupil by the states neighboring Oklahoma: Missouri, Texas, Kansas, Arkansas, Colorado and New Mexico. Robison said he would hope some of the additional money provided to education, if SQ 744 is approved, would be used for teacher salaries and benefits to recruit and keep the best teachers in Oklahoma. SQ 744 is scheduled to appear on the Nov. 2 ballot.
Author: Erin Boeckman
Date: 09/01/2010
The board met Wednesday in response to the Oklahoma Supreme Court's recent decision finding unconstitutional a 1 percent health access fee on paid insurance claims. The fee was calculated in the board's expense and trend assumptions in developing plan rates for 2011 and was expected to add $6.2 million in costs. With the court's ruling, that assessment was no longer needed.
The board voted 7 to 1 to apply the savings to OSEEGIB's plan rates, yielding about a 1 percent decrease in the rates that had been approved by the board previously on Aug. 20. The lone nay vote came from board member and Office of State Finance Director Michael Clingman, who suggested applying the $6.2 million equally between premium rates and copays.
Clingman suggested decreasing the copay for primary office care visits from the $30 approved for 2011 to $25, which was the cost prior to Jan. 1, 2010, when a $50 copay went into effect. He also suggested lowering the copay for specialist care visits from $50 to $40.
Clingman said he could not find any other health care policy in the state with a $50 copay for specialist care. Teachers and state employees who use the plan do not have any better ability to pay such an amount as any other resident, he said.
"Decreasing the copay would really help these families," he said.
Specialist care represents 40 percent of the office visits of OSEEGIB members, he said.
Frank Stone, chief actuary for the Oklahoma Insurance Department, seconded Clingman's motion. He serves on the board in the absence of Insurance Commissioner Kim Holland, who brought the lawsuit challenging the constitutionality of HB 2437, by Rep. Doug Cox, R-Grove, and Sen. Mike Johnson, R-Kingfisher, which would have required all health carriers to pay to the insurance commissioner an access payment of 1 percent on all claims paid beginning from the effective date of the act until Jan. 1, 2015. The funds were intended to support the state's Medicaid program.
Holland was absent from Wednesday's meeting, but she supported Stone's action. She also supports returning the primary care physician copay to $25, according to Marc Young, assistant commissioner of public affairs for the Insurance Department.
As chief actuary, Stone examined the issues from the standpoint of fiscal solvency to ensure the rates were adequate to pay for the claims that will be incurred, Young said. The board is expecting $6 million in new claims above what was paid the prior year. Given the savings from HB 2437 being ruled unconstitutional, Holland supported returning money to the policyholders and the state, which pays the majority of the premium for state and education employees.
"It's a win-win for the state and policyholders," Young said.
The Oklahoma Public Employees Association also supported a copay decrease. Jimmy Durant, a membership representative with OPEA, said that state employees across the state were more upset about copay increases instituted in 2010 than they were about rate increases. While OPEA members appreciated a rate decrease, Durant asked the board also to consider reducing the primary care office copay to $25.
The board voted 6-to-2 against Clingman's motion.
It was the feeling of the board that because the $6.2 million was part of the original calculation for premium rates, that is where it should stay, said Mark Liotta, a recent addition to the board and a former member of the House of Representatives. He said the board would have an opportunity next year to look at adjusting copays.
While the premium rate will only increase by 1.51 percent instead of the 2.5 percent previously expected for 2011, Clingman said he is still concerned that the additional expense will take its toll on state agencies. It comes down to how much of a burden is placed on agencies versus employees. Clingman said he thinks the board could have helped both. Even with a 1.51 percent rate increase, he said he is concerned agencies will respond with more furloughs and reductions in force.
Decisions in light of federal health care reform
As a self-funded plan, OSEEGIB's first priority is to its reserves, especially in light of upcoming federal health care reforms, Liotta said.
"A lot of expenses are coming our way that we need to be prepared for," Liotta said.
Portions of the Patient Protection and Affordable Care Act are already in place and were adopted as part of the changes for OSEEGIB's policies in 2011. For example, health plans beginning on or after Sept. 23, 2010, are required to offer coverage for policyholders' children until age 26. The 2011 HealthChoice plans include this coverage.
The future of health care is murky and unpredictable under the Patient Protection and Affordable Care Act, Liotta said. Therefore, it is wise that the board keeps a conservative approach to decreasing copays and premiums, he said.
Under the reform, insurance providers for large employer plans are also required by Jan. 1, 2011, to spend at least 85 percent of all premium dollars on health care services and health care quality improvement. OSEEGIB is already ahead of that curve, said Frank Wilson, administrator of the agency. OSEEGIB has historically spent 95 percent of its premium dollars on health plan costs, he said.
Author: Shawn Ashley & Erin Boeckman
Date: 09/01/2010
While initial rates were approved by both bodies on Aug. 20, Wednesday's action became necessary after the Oklahoma Supreme Court on Aug. 24 ruled unconstitutional legislation passed earlier this year creating a 1 percent fee on insurance claims paid by providers, preventing its implementation Aug. 27. Six justices concurred in the opinion granting jurisdiction and ruling HB 2437 unconstitutional. The bill, by Rep. Doug Cox, R-Grove, and Sen. Mike Johnson, R-Kingfisher, would have required all health carriers to pay the insurance commissioner an access payment of 1 percent on all claims paid from the effective date of the bill until Jan. 1, 2015. According to information from the Oklahoma Health Care Authority, the fee was expected to generate $52 million during fiscal year 2011. The funds were intended to support the state's Medicaid program.
The justices agreed with Insurance Commissioner Kim Holland, who brought the challenge, that the bill did not follow appropriate procedures for final legislative passage. Michael Ridgeway, Holland's attorney, argued and the court agreed that the bill did not comply with Article 5, Section 33 of the Oklahoma Constitution, regarding revenue-raising measures.
EBC members went immediately into executive session to discuss the new rates and approved them without discussion or debate.
Under the contracts approved Wednesday, CommunityCare will charge $772.34 for employee-only coverage under its standard plan, a reduction of 0.8 percent from the rates approved Aug. 20. The cost for GlobalHealth's standard plan for employee-only coverage will be $366.56, which is 0.9 percent less than the previously approved rate. PacifiCare's premium for its standard plan for employee-only coverage will be $686.42 or 1 percent less than the rate approved Aug. 20.
Additional rates apply if employees choose to cover their spouse and dependents. The rates for dental and vision insurance offered by private carriers under contract with EBC were not affected by Wednesday's decision, EBC Chairman Bryce Fair noted.
The court's decision to rule HB 2437 unconstitutional also meant that $6.2 million built into OSEEGIB's assessments for 2011 was no longer necessary. As such, the board decided to apply the savings across the board to premiums, resulting in about a 1 percent decrease in the plan rates that were previously approved on Aug. 20.
The board decided Wednesday that rather than the 2.5 percent rate increase previously approved for primary active and pre-Medicare members of the HealthChoice High Option plan, the rate for 2011 will only increase by 1.51 percent. This equates to an increase of $6.68 in the premium for primary members of the HealthChoice High Option plan rather than an $11.02 increase. That means the rate for employee-only coverage under the plan will cost $449.48. The HealthChoice High Option plan is the most popular plan offered by OSEEGIB.
The board also approved the following rate adjustments for 2011:
• 1.93 percent increase for primary members of the HealthChoice Basic Plan;
• 1.51 percent increase for primary members of the HealthChoice USA Plan; and
• 4.58 percent increase for primary members of the HealthChoice High Deductible Plan, which is used in conjunction with health savings accounts.
The rates for OSEEGIB's dental, life and disability plans did not change after they were approved Aug. 20.
The copay amounts approved on Aug. 20 also will not change, despite efforts by board member and Office of State Finance Director Michael Clingman. The copay for primary office visits that had increased to $50 for 2010 will be $30 in 2011. The copay for specialist care visits will remain at $50.
Clingman suggested that the $6.2 million decrease in calculated assessments should be used to lower the premium rates and to decrease the copays. Specifically, he suggested lowering the primary care copay to $25 and the specialist care copay to $40. Frank Stone, chief actuary for the Oklahoma Insurance Department and Insurance Commissioner Kim Holland's proxy in her absence, supported Clingman's motion, but it failed in 6-to-2 vote. [Editor's Note: See related story on the board's discussion on copay adjustments.]
The adjusted rates were approved in a 7-to-1 vote, with Clingman casting the lone vote in opposition. They take effect on Jan. 1, 2011.
Wednesday's adjustments also will result in a slight decrease in state employees' benefit allowance, EBC reported. Under state law, the benefit allowance is based on the average of the highest-cost HMO and HealthChoice plans, plus an average of the dental plans' costs, the basic life insurance and disability premiums and 75 percent of dependents' health insurance premium cost. The EBC reported Wednesday that the employee-only benefit allowance will be $603.29 for plan year 2011, a decrease from its $608.57 level for the current plan year. The reduction will result in a statewide savings of approximately $3.42 million, EBC noted in a press release.
Complete rate information for the HMOs and other premiums approved by EBC can be found at www.ebc.state.ok.us. HealthChoice rates are available at www.sib.state.ok.us.
The enrollment period for the plan year 2011 benefits, which coincides with the calendar year, begins Oct. 4 and closes Oct. 29. The new rates will take effect Jan. 1, 2011.
Author: Erin Boeckman
Date: 08/31/2010
The discussion was part of Rep. Jason Nelson's Interim Study 2010H-076 to monitor the implementation of HB 3393, which created the Lindsey Nicole Henry Scholarships for Students with Disabilities Program Act. The act, which went into effect Friday, provides a scholarship to a private school of choice for students with disabilities for whom an individualized education program, or IEP, has been developed, to be awarded beginning with the 2010-2011 school year. Nelson, R-Oklahoma City, was the House author of the bill.
As of Tuesday morning, the Department of Education had received no official requests for the scholarship, said Misty Kimbrough, assistant state superintendent of special education services for the department. However, there have been lots of questions regarding the new scholarship program.
Kimbrough said she has fielded 96 calls from parents since June 1. While there have been no requests to make use of the scholarship, she said she expects there will be now that the bill is in effect.
So far, Tulsa parents seem to be expressing the most interest in the program. Kimbrough said the majority of calls came from parents with students in the Tulsa, Broken Arrow and Jenks school districts. A possible reason for this is the presence of Tulsa Town & Country School.
The school is a 501(c)(3) organization that provides education and services to students in first through 12th grades who have been diagnosed with learning disabilities, attention disorders and Asperger's Syndrome, according to the school's website.
In addition to Tulsa Town & Country School, 11 other private schools have opted into the scholarship program, as set forth in HB 3393, Kimbrough said. She said she has also been contacted by the leader of the state's Catholic private schools, which may lead to the addition of around 20 more schools to the opt-in list.
Questions from members of the committee centered on how the program intertwined with public schools' programs under the Individuals with Disabilities Education Act.
Rep. Al McAffrey, D-Oklahoma City, said he was concerned about tracking the funds that were being transferred from public schools to provide private school scholarships. Kimbrough said it is the Department of Education's intent to track the funding by tracking students via annual child-count reports to the Department of Education and via the Wave, which is the department's statewide student information system. Nelson said he hopes the information can be used to compare the amount of the scholarship with the cost of providing services to students in public schools to see if there is a cost savings or expense.
As with other transfers, schools will be able to count a student who accepts a scholarship and begins a private school for up to two years on their student count reports. This policy helps schools absorb fixed costs, Nelson said.
Larry Smith, assistant to the superintendent for accountability at Tulsa Public Schools, asked if a district continuing to count a student who has transferred under a private school scholarship would be penalized for not testing that student. Under state law, private schools are not required to administer standard tests that are required in public schools. Kimbrough said students under the scholarship program will not count for or against the public school's performance as measured by state tests.
Implementation of HB 3393 will be studied further on Sept. 14, when the Human Services Committee is scheduled to meet again. By that time, there should be more information available regarding students making use of the scholarship, Nelson said.
HB 3393 was also sponsored by Sen. Patrick Anderson, R-Enid. It allows a parent or legal guardian of a public school student with a disability to exercise their parental option and request to have a scholarship awarded for the child to enroll in and attend a private school if the student has spent the prior year at a public school and the student has been accepted into a private school eligible for the scholarship program. The bill establishes parameters for private schools to qualify to participate in the scholarship program, including meeting the accreditation requirements set by the State Board of Education or another accrediting association and demonstrating fiscal soundness through one year of operation or providing the Department of Education a statement from a certified public accountant. The bill also establishes parameters for student participation and payment of the scholarship. It states that no liability shall arise on the part of the state or a school district based on the award or use of any scholarship provided under the act.
Author: Clint Sloan
Date: 08/30/2010
The event occurred at the Oklahoma History Center and was sponsored by the Oklahoma Rehabilitation Council and the Heartland Council for the Blind. The candidates discussed education, transportation, budgetary matters and job creation, along with other issues.
House District 84 Rep. Sally Kern, R-Oklahoma City, was the first to speak.
"One of the things that's near and dear to my heart is education," Kern said. "I've been fortunate to get legislation passed to advance education."
Kern said she was instrumental in passing HB 3393. Kern said the bill, which she co-sponsored, provides more opportunities for disabled students.
The bill, by Rep. Jason Nelson, R-Oklahoma City, and Sen. Patrick Anderson, R-Enid, creates the Lindsey Nicole Henry Scholarships for Students with Disabilities Program Act to provide a scholarship to a private school of choice for students with disabilities for whom an individualized education program, or IEP, has been developed, to be awarded beginning with the 2010-2011 school year. The bill allows a parent or legal guardian of a public school student with a disability to exercise their parental option and request to have a scholarship awarded for the child to enroll in and attend a private school if the student has spent the prior year at a public school and the student has been accepted into a private school eligible for the scholarship program. The bill establishes parameters for private schools to qualify to participate in the scholarship program, including meeting the accreditation requirements set by the State Board of Education or another accrediting association and demonstrating fiscal soundness through one year of operation or providing the Department of Education a statement from a certified public accountant. The bill also establishes parameters for student participation and payment of the scholarship. It states that no liability shall arise on the part of the state or a school district based on the award or use of any scholarship provided under the act.
Kern said she would also support a bill that would make the federal Americans with Disabilities Act state law.
"If there's no enforcement, then it should be voted in," Kern said.
Nelson, who is seeking re-election in House District 87, said the state should look for ways to fund programs that benefit the disabled without raising taxes.
"It's an issue with priorities," Nelson said. "We need to identify dollars that are wasted."
Nelson also pointed to HB 3393, acknowledging that the legislation he sponsored was very important to disabled citizens.
House District 84 Democratic candidate Brittany Novotny said she would support a dedicated tax in order to provide a mass transportation system in Oklahoma City, criticizing proposals to cut wasteful spending to fund a transportation system.
"I'm not going to be the politician that promises to cut taxes while promising to give you more services," Novotny said.
J.P. Hemminger, a Democratic candidate running for House District 43, said he would support a mass transit system in order for the disabled and older citizens to have adequate transportation.
"I agree with the need for cooperation, understanding and agreement with funding a public transportation system in Oklahoma City," Hemminger said.
House District 53 Democratic candidate Amy Corley said she knows what disabled citizens go through.
"I'm a mother of a child with a disability," Corley said.
Corley said that disabled Oklahomans need more public transportation in order to perform everyday activities.
"We don't have enough of it," Corley said. "We bypass the basic issue of how we're trying to get them from their home to work."
Dana Orwig, Nelson's Democratic challenger in House District 87, said all levels of government should work together to create a better transportation system so disabled citizens could enjoy the newly renovated downtown Oklahoma City area.
"The best way to approach that is that federal, state and local governments work together," Orwig said. "It's frustrating to me that they paid for the improvements downtown, and they can't get there."
Rep. Charles Joyner, R-Midwest City, who is running for re-election in House District 95, is vice chairman of the House Transportation Committee. He said he is interested in creating a transit authority that includes Norman, Edmond and Midwest City.
"If any of the three doesn't want to do it, then the authority would not take place," Joyner said.
Dominique Block, a Republican candidate running for House District 88, said fixing the budget would be the first step toward helping the disabled.
"There is no guarantee that Congress will give us any money this year," Block said. "We need to reform how revenue is coming in."
The Americans with Disabilities Act must become state law because Block said Oklahoma does not do an adequate job in enforcing federal law.
"There is not a lot of enforcement here in Oklahoma," Block said.
House District 45 Rep. Wallace Collins, D-Norman, said one of his main concerns is the budget. Collins said he wants to find funding in order to save facilities that benefit the disabled, including the recently closed Children's Recovery Center.
"All these families have been impacted by the budget cuts," Collins said.
Randy Rose, the Democratic candidate running for Senate District 44, said he is not ignorant of how state government works and that he would stand up for disabled Oklahomans if elected.
"We're seeing cuts on the people that need the services," Rose said. "This issue has to stop."
House District 101 Democratic candidate Johnny Laudermilk said job creation should be the first priority of state government.
"We need to look for ways to create jobs," Laudermilk said. "We need to make sure to have educational opportunities in order to do that."
Clark Duffe, Independent candidate for the Fifth Congressional District, said the federal government needs to put issues that affect disabled citizens higher on the priority list.
"We are $13 trillion in debt," Duffe said. "We have to prioritize our spending."
The Fifth Congressional District's Democratic candidate Billy Coyle said the main issues that have his attention are jobs and energy.
"We need to focus on a national energy plan in order to get jobs in this district," he said. "It's critical in America right now that we get America working again."
Dave White, an Independent candidate also running for the Fifth Congressional District, said he would help disabled citizens by repealing President Barack Obama's health care plan.
"I believe that competition works," White said. "We had the greatest system in the world. All it needs is a few tweaks."
House District 91 Democratic candidate Hollis Harper said his main campaign issue is enhancing law enforcement in order to keep citizens safe.
"I believe that we can improve law enforcement by consolidating all of our state enforcement agencies," Harper said. "It will also save the state money."
Daniel Stankiewicz, an Independent candidate for House District 97, said he would represent the disabled citizens of his district better because he would not try to please a party caucus if elected.
"I believe in voting with the majority of what my constituency wants, not what [caucus members] want," Stankiewicz said.
Sid Hudson, the campaign manager for Democratic gubernatorial candidate and Lt. Gov. Jari Askins, said Askins is a person with integrity who would work hard to fight for issues that benefit disabled Oklahomans.
"I think she is the same person I met in 1988," Hudson said. "She would be a great governor."
Edward Shadid, a surgeon who is running as an Independent for House District 85, said his campaign is focused on allowing more third-party candidates to be placed on the Oklahoma ballot.
"Oklahoma is the most restrictive state in the country to put third-party candidates on the ballot," Shadid said.
Author: Erin Boeckman
Date: 08/30/2010
As the state attempts to recover from an economic recession, Brown, D-Tahlequah, is focusing his efforts on ways to boost the economy and create jobs. Tax credits play a big role in the discussion of both, he said.
"One side has banked on tax credits as being the holy grail of bringing in business," he said. "We have to be business friendly, no doubt, but you also have to have balance."
The Legislature was lucky that it had the federal stimulus and the Rainy Day Fund to help balance the budget, but some of those funds were squandered in providing tax credits that will end up hurting the state in the long run, he said.
"If those tax credits had strings attached to them to ensure job creation, we would have had an increased tax base," Brown said. Instead, the dependency on tax credits created corporate welfare, and the recipients are likely to keep coming back looking for more assistance, he said.
"We tie strings to teachers and educators to produce, so we ought to do the same thing for business," Brown said. "If you're not producing, then why do we give you credits?"
When nearly 30 tax credits were placed on a two-year moratorium during the 2010 legislative session, legislators were told there would be a review of the state's tax credits. Brown said he does not mind seeing all tax credits on the table for review. However, the impact of those tax credits, especially on rural parts of the state like House District 4, need to be reviewed, as well.
Assistance should also be given to small businesses, which are often left out of tax credit discussions, Brown said.
"I'm a small business owner," he said. "Small businesses produce the largest amount of income in Oklahoma, but they do not enjoy the same level of tax credits. If we gave small businesses the same opportunities that we give large businesses, I think small businesses would really thrive in Oklahoma."
Brown also lamented that the state did not provide more assistance to small businesses that have operated in Oklahoma for 20 years or longer, instead of offering enticements to large businesses to come to Oklahoma.
While looking at where the state is spending its money, the Legislature should also look at where there is insufficient spending. Brown said he supports cutting wasteful spending, but in some areas there is no more fat to trim.
"We can't cut every agency's spending to balance the budget on their backs," he said. "I believe the tax base right now is adequate enough to maintain agencies, bridges and other infrastructure, schools and health care."
When the Legislature returns in 2011 to sculpt the next year's budget, Brown said cutting spending to all agencies is not the answer. Cutting things to the bone means it cannot operate properly.
Such is the case for the Department of Corrections. Brown said he was afraid the state would lose quality corrections officers due to budget cuts and would have to replace them with inadequate officers. Other cutbacks at prisons could lead to unsafe conditions.
"If we're going to be tough on crime, then we need to fund it," Brown said.
Access to health care, including Nick's Law, will also be a focus for Brown if re-elected to a fourth term.
Nick's Law has been a perennial proposal to require insurance companies to provide coverage for the treatment of an autistic disorder. In 2009, Brown sponsored the House legislation proposing Nick's Law - HB 1312 - that was given a do not pass during the first week of the legislative session. That action essentially quashed any consideration of the measure for the 2009 and 2010 legislative sessions.
"I don't know why leadership took such action to kill the bill," Brown said. He said he has not seen such a motion pass so early in session without efforts to work through the bill.
However, with a new session comes a new opportunity to introduce Nick's Law. Brown said he plans to tweak the language in the hopes of making it more palatable to legislators.
"I believe 80 percent of Oklahomans approve of Nick's Law in some form or fashion," he added.
During the 2010 session, Brown was successful in sponsoring legislation to ensure that victims of domestic violence could not be denied coverage based on pre-existing condition provisions.
SB 1251, by Sen. Jim Wilson, D-Tahlequah, and Brown, prohibits health benefit plans from denying coverage, refusing to issue or renew coverage, cancel or otherwise terminate, restrict or exclude any person from any health benefit plan issued or renewed on or after Nov. 1, 2010, on the basis of the applicant's or insured's status as a victim of domestic abuse. It also prohibits health benefit plans from denying a claim on the basis of the insured's status as a victim of domestic violence, and it prohibits domestic abuse from being considered a preexisting condition. In the House, language was added stating that in order to comply with the provisions, the acts constituting the domestic abuse must be reported to a law enforcement agency setting forth the relevant facts.
As he looks forward to filing legislation for consideration in the 2011 session, Brown said he hopes to work with Speaker-elect Kris Steele, R-Shawnee, on a lot of health care issues.
Brown is being challenged by Republican Dwayne Thompson for the House District 4 seat, which includes Cherokee County.
Author: Shawn Ashley
Date: 08/27/2010
The EBC approved new rates Aug. 20 for plan year 2011 for three health maintenance organizations that will offer insurance to state employees. OSEEGIB approved rates for its HealthChoice insurance plans the same day.
"The [EBC] meeting will be for the purpose of approving revised rates based on the state Supreme Court's ruling," Bryan King, communications director for the Employee Benefits Council, said Friday.
Hilary Johnston, public information officer with OSEEGIB, said, "The board is going to consider lowering the premiums by what the assessment would have been."
On Tuesday, the Oklahoma Supreme Court ruled unconstitutional legislation passed earlier this year creating a 1 percent fee on insurance claims paid by providers, preventing its implementation Friday. Six justices concurred in the opinion granting jurisdiction and ruling HB 2437 unconstitutional. The bill, by Rep. Doug Cox, R-Grove, and Sen. Mike Johnson, R-Kingfisher, would have required all health carriers to pay the insurance commissioner an access payment of 1 percent on all claims paid from the effective date of the bill until Jan. 1, 2015. According to information from the Oklahoma Health Care Authority, the fee was expected to generate $52 million during fiscal year 2011. The funds were intended to support the state's Medicaid program. [Editor's Note: See related story on the Oklahoma Health Care Authority's budget.]
The justices agreed with Insurance Commissioner Kim Holland, who brought the challenge, that the bill did not follow appropriate procedures for final legislative passage. Michael Ridgeway, Holland's attorney, argued and the court agreed that the bill did not comply with Article 5, Section 33 of the Oklahoma Constitution, regarding revenue-raising measures.
That portion of the Constitution requires that revenue-raising bills receive a three-fourths vote of the House and Senate. HB 2437 passed 59 to 33 in the House and 29 to 14 in the Senate. A three-fourths vote would have required 76 votes in the House and 36 votes in the Senate. The Constitution also stipulates that revenue-raising bills cannot be passed during the last five days of the legislative session. HB 2437 passed the House on Friday, May 21, prior to the last five days, but it did not pass the Senate until Monday, May 24, which was within the five-day time period. The Legislature adjourned on May 28.
The EBC and OSEEGIB meetings are necessary, King explained, since the previously approved rates were formulated on the basis that the fee would be in place.
"When the HMOs submitted their rates and those rates were negotiated with EBC over the last couple of months, the rates assumed the 1 percent fee [would be in place] and was factored into the rates," he said. "When the 1 percent fee goes away, it provides an opportunity for the providers to offer a different rate."
Johnston said she did not yet have an estimate of the impact removing the fee would have on the rates. But, she noted, "When the premiums are reduced it impacts all our state agencies and school districts."
Johnston said the board also may reconsider a move to reduce the copays members pay for services. Board members voted Aug. 20 to reduce the copay for members' primary care office visits from $50 to $30.
"Several board members really wanted the copay reduced an additional $5," Johnston said.
The council originally was scheduled to meet Friday, but that meeting was rescheduled for Wednesday, King said, so the two bodies could meet simultaneously.
"Meeting at the same time avoids any possibility of shadow-pricing," King said.
Both meetings are set for Wednesday at 10 a.m.
Author: House Media
Date: 08/27/2010
"The Lindsey Nicole Henry Scholarships for Students with Disabilities Program Act became law today, and it's very important that the families of special needs children are aware of this opportunity and take advantage of it," said Nelson, R-Oklahoma City. "This program creates new opportunities for many children who would otherwise be unable to obtain educational services truly tailored to their unique needs."
Under House Bill 3393, children with disabilities who have an individualized education program (IEP) qualify for a scholarship to attend any private school that meets the accreditation requirements of the State Board of Education.
The legislation, authored by Nelson and by state Sen. Patrick Anderson, had strong support from many families of children with autism.
The state Board of Education finalized the rules allowing implementation of the scholarship program on August 26, and parents can now contact their resident school district to apply for the program, Nelson said.
"Having visited with many parents of special-needs students, I know how important this scholarship program is to those families," Nelson said. "It will allow those parents to provide the best education and best future possible for their children beginning this school year. Every parent interested in this program should take advantage of it."
The scholarship program created through House Bill 3393 does not require new spending, but merely redirects existing state funds that are currently spent on the student.
Other states with similar laws include Florida, Georgia, Utah, Ohio and Arizona. The Florida program has been in place since 1999 and now serves approximately 20,000 students with special needs. House Bill 3393 closely mirrors the Florida and Georgia laws.
The legislation has been named the Lindsey Nicole Henry Scholarships for Students with Disabilities Program Act to honor the memory of one of the Gov. Brad Henry's daughters, who died of a rare neuromuscular disease as an infant.
Lawmakers will soon conduct a legislative study on the new law to seek ways to increase its benefit for Oklahoma families. The first meeting will be held Aug. 31 with a second study date to be scheduled later.
Author: Erin Boeckman
Date: 08/24/2010
Six justices concurred in the opinion granting jurisdiction and ruling HB 2437 unconstitutional. The 2010 bill, by Rep. Doug Cox, R-Grove, and Sen. Mike Johnson, R-Kingfisher, would have required all health carriers to pay the insurance commissioner an access payment of 1 percent on all claims paid from the effective date of the bill until Jan. 1, 2015. According to information from the Oklahoma Health Care Authority, the fee was expected to generate $52 million during fiscal year 2011. The funds were intended to support the state's Medicaid program. The bill was scheduled to go into effect on Friday.
The justices agreed with Insurance Commissioner Kim Holland, who brought the challenge, that the bill did not follow appropriate procedures for final passage through the Legislature.
Specifically, Holland's attorney Michael Ridgeway argued, and the court agreed, that HB 2437 did not comply with Article 5, Section 33 of the Oklahoma Constitution, regarding revenue-raising measures.
According to the Constitution, revenue-raising bills must receive a three-fourths vote of the House and Senate. HB 2437 passed 59 to 33 in the House and 29 to 14 in the Senate. A three-fourths vote would have required 76 votes in the House and 36 votes in the Senate. According to the Constitution, revenue-raising bills also cannot be passed during the last five days of session. HB 2437 passed the House on Friday, May 21, prior to the last five days, but it did not pass the Senate until Monday, May 24, which was within the five-day time period. The Legislature adjourned on May 28.
Chief Justice James Edmondson, Vice Chief Justice Steven Taylor and Justices Yvonne Kauger, Joseph Watt, James Winchester and Tom Colbert concurred in the opinion. Justice John Reif agreed with the court's decision to grant jurisdiction, but he did not concur with finding HB 2437 unconstitutional.
"In my opinion, HB 2437 is a constitutionally permissible fee related to the provision and regulation of health insurance in the state of Oklahoma," Reif wrote in his opinion.
Justice Marian Opala, however, dissented in the decision to grant jurisdiction and suggested it should have been referred to a district court to determine whether the fee contained within HB 2437 was a "true tax." Justice Rudolph Hargrave concurred with Opala.
After hearing of the opinion, Holland issued a statement praising the court's decision.
"Today's decision is a victory for all Oklahomans who believe that our Constitution is worth upholding," she said in a news release. "I appreciate the court's expediency in looking into this matter. With this decision, my department accomplished all we set out to achieve - to ensure that we adhere to the Constitution and the laws of our state."
Impact on Medicaid funding
While failing to enact the insurance fee would mean the loss of an estimated $52 million for Medicaid this fiscal year, the leader of the Oklahoma Health Care Authority and Gov. Brad Henry's office pointed to federal funds that may help soften the blow.
"We do not see a reason to panic at this point," said Michael Fogarty, chief executive officer of the Health Care Authority, in a statement. "Since the Oklahoma Legislature adjourned in May, the federal government has made additional funds available to states by extending the enhanced Federal Medical Assistance Percentages (FMAP). The enhanced FMAP was set to expire Dec. 31 and it was extended until June 30, 2011. We estimate this extension will make an additional $140 million to $150 million available for the Oklahoma Health Care Authority."
President Barack Obama signed the Education Jobs Fund legislation into law on Aug. 10. In addition to providing funding to states for education-related expenses, the bill extended the enhanced Medicaid assistance initially granted under the American Recovery and Reinvestment Act.
Paul Sund, Henry's communications director, also expressed optimism that the federal funds would help Oklahoma move forward without disruptions in its health care programs for the current fiscal year. However, both he and Fogarty said they were concerned about the fiscal years to come.
The downside of using the federal funds in FY2011 is that the governor and Legislature are expected to have less revenue when they craft the FY2012 budget during the next session, Fogarty said. From a long-term budgeting perspective, the loss of revenue will be disruptive at a time when the state is pulling itself out of a historic budget crisis, Sund added in a news release.
"Because those federal funds are one-time dollars that must be replaced by the state next fiscal year, Oklahoma will face significant funding challenges in health care and other important programs when the Legislature returns in 2011," Sund said in a statement.
Fogarty said he would be working with the Health Care Authority's Board of Directors and state legislators to ensure the agency has the appropriate authority to use the newly available federal funds to help balance its budget.
Sund said the governor's office would be reviewing the court decision's short-term and long-term budgetary implications with legislative leaders in the days to come.
Meanwhile, some members of the Legislature were quick to praise the court's decision in finding HB 2437 unconstitutional.
"I applaud the Supreme Court's decision affirming that the provider fee is in fact a tax," said House Appropriations and Budget Chairman Kenneth Miller, R-Edmond, in a news release. "As details of this proposal became clear during the final days of session, I advised against and voted against its passage, strongly believing the bill to be a tax increase."
With regard to the upcoming budget challenges, Miller, who is the Republican candidate for state treasurer, said they must be addressed in a fiscally responsible manner without placing additional burdens on taxpayers.
Rep. Daniel Sullivan, R-Tulsa, who debated against the measure on the House floor, called the proposed insurance fee an "unnecessary tax on business." He suggested the fee would be passed on to consumers, which would allow an opportunity for more people to be priced out of health insurance.
Rep. Mike Ritze, R-Broken Arrow, also suggested that the insurance fee would have led to higher insurance premiums.
"As a doctor, I know how difficult it is for many Oklahomans to afford health care coverage, which is why I opposed this new tax," Ritze said in a news release. "It's just common sense. Higher prices lead to lower consumption, which is why we should try to keep insurance rates as low as possible. House Bill 2437 would have done the opposite."
Ritze is one of two physicians serving in the Oklahoma Legislature. Cox, the House author of HB 2437, is the other physician.
While Cox could not be reached for comment before press time Tuesday, he argued on the House floor that HB 2437 may increase premiums, but it would also decrease the cost shift of uncompensated care to the insured, thus reducing premiums for the insured.
Author: Erin Boeckman
Date: 08/23/2010
Insurance Commissioner Kim Holland brought the suit challenging the constitutionality of HB 2437, which requires all health carriers to pay the insurance commissioner an access payment of 1 percent on all claims paid from the effective date of the bill until Jan. 1, 2015. According to the bill, the funds are intended to support the state's Medicaid program, which is operated by the Oklahoma Health Care Authority.
Holland's attorney Michael Ridgeway reiterated arguments he made before a Supreme Court referee earlier this month in charging that HB 2437 was a revenue-raising measure and did not follow the procedures set forth in the Oklahoma Constitution for passage.
According to Article 5, Section 33 of the Constitution, revenue-raising bills must receive a three-fourths vote of the House and Senate. HB 2437 passed 59 to 33 in the House and 29 to 14 in the Senate. A three-fourths vote would have required 76 votes in the House and 36 votes in the Senate. According to the Constitution, revenue-raising bills also cannot be passed during the last five days of session. HB 2437 passed the House on Friday, May 21, prior to the last five days, but it did not pass the Senate until Monday, May 24, which was within the five-day time period. The Legislature adjourned on May 28.
In response to a question from Justice Marian Opala regarding the difference between a fee and a tax, Ridgeway argued Monday that the purpose of a fee is to compensate the state for people or facilities, not services, as is the case with the health access fee created in HB 2437.
Assistant Attorney General Scott Boughton, speaking on behalf of the Office of State Finance and the state treasurer which are respondents in the case, said that the court must look beyond simply whether the bill raises revenue and determine the purpose of the legislation. HB 2437 was passed for the "public well being" to increase funding and therefore access to health care for Oklahomans, Boughton said.
Boughton cited the 2000 Supreme Court case of Calvey v. Daxon, in which former Rep. Kevin Calvey, R-Del City, and other representatives challenged former Office of State Finance Director Tom Daxon regarding two bills that transferred fee-generated revenue into the Special Cash Fund. The petitioners argued that the legislation did not abide by the same section of the Constitution mentioned in Ridgeway's argument. However, the court found "revenue bills" are those with the principal object of raising revenue and levy taxes in the strict sense of the word. Laws under which revenue may incidentally arise are not "revenue" bills within the meaning of the Constitution, according to the court's opinion. This definition applies to the revenue generated in HB 2437, Boughton argued.
"We believe the purpose of this bill is not revenue raising," echoed Howard Pallotta, general counsel for the Oklahoma Health Care Authority, another respondent in the case.
Adding to his argument that raising revenue is "incidental" to HB 2437, Pallotta suggested that the purpose of the bill was to replace funds the Health Care Authority spends on Insure Oklahoma. The program provides premium assistance to employers and individuals toward the purchase of health insurance.
When asked about the amount of revenue raised and the burden placed on the insurance commissioner in administering the legislation - a point argued by Ridgeway - Pallotta said such points were "undeveloped facts." The Supreme Court is an appellate court granted the authority to determine questions of law. The $77 million or $78 million estimated earnings from the health access fee are just that, estimates and not facts, Pallotta said.
Furthermore, Pallotta suggested that the petitioner had not proved its case beyond a reasonable doubt for the court to find HB 2437 unconstitutional. He asked the justices to deny declaratory judgment and injunctive relief sought for by Holland in the case.
Following the presentation of arguments, Chief Justice James Edmondson advised that the justices would be convening in conference. There was no announcement regarding when a decision may be made. HB 2437 is set to go into effect on Friday, according to Ridgeway.
Speaking to reporters, Ridgeway said he believed the case was made that HB 2437 was very clearly a revenue bill. However, Pallotta said he was confident the justices understood they must look at the purpose of the legislation.
The legislation, by Rep. Doug Cox, R-Grove, and Sen. Mike Johnson, R-Kingfisher, states that the Health Carrier Access Payment Revolving Fund in the State Treasury is to be used by the Oklahoma Health Care Authority to fund the state's Medicaid program and make full use of any federal matching funds available to the state. The bill requires all health carriers to pay to the insurance commissioner an access payment of 1 percent on all claims paid beginning from the effective date of the act until Jan. 1, 2015. It requires the payments to be made to the insurance commissioner monthly on all claims paid and incurred beginning July 1, 2010. It requires the insurance commissioner to pay collected funds to the State Treasury weekly. The bill allows the insurance commissioner to refuse to renew, suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in the state of any health carrier failing to pay an access payment. It also allows the commissioner to assess civil penalties and collect reasonable attorney fees if judicial action is necessary for enforcement.
Author: Justin Martino
Date: 08/13/2010
According to a report by the National Conference of State Legislatures, 44 state legislatures passed 191 laws and adopted 128 resolutions in the first half of 2010. Oklahoma enacted 10 of the laws and resolutions listed in the report.
The national numbers represent a 21 percent increase from 2009, when 44 states enacted 144 laws and adopted 115 resolutions. There has been a significant increase in laws in the last few years, after only 38 laws related to immigration were passed in 2005.
While some of the Oklahoma laws listed in the NCSL report, such as SB 2258 on human trafficking, relate directly to the legal status of immigrants, others are less directly related, such as SR 97, which honors a man who started a Vietnamese language newspaper in Oklahoma.
Nationally, Arizona's SB 1070 received the most attention of the immigration laws this year. The legislation requires law enforcement officials to reasonably attempt to determine the immigration status of a person if reasonable suspicion of an unlawful presence exists.
As of the end of June, five other states had introduced similar legislation, though the legislative sessions have ended in two of those states. Several Oklahoma legislators announced intentions to propose similar legislation, but no bill was ever produced.
Rep. Randy Terrill, R-Moore, said he would be able to gain sufficient support in the House to pass a bill mirroring Arizona's law sponsored by himself, Rep. Mike Christian R-Oklahoma City, Rep. Rex Duncan, R-Sand Springs, and Sen. Anthony Sykes, R-Moore. Duncan is seeking a district attorney position and will not be returning to the Oklahoma House, but Sykes recently won re-election to the Senate, and Terrill and Christian are seeking re-election in November.
Several other bills related to immigration were introduced in the Legislature but not passed.
Christian and Sykes sponsored HB 3341, which would have made it illegal for any person who is not lawfully in the United States to possess or have under his or her immediate control any firearm. It also would have made it a felony for any person issued a concealed handgun license to allow an illegal alien to possess or have control of any pistol. The conference committee report for the bill added language that would have made possession of a firearm by an illegal alien a felony. The conference committee version of the bill did not receive a House floor hearing before the end of session.
Another measure relating to the law passed in Arizona was HR 1095. The resolution, by Rep. Mike Reynolds, R-Oklahoma City, commends the state of Arizona for enacting Arizona Senate Bill 1070. The resolution was introduced on May 12, but it never received a hearing.
As Oklahoma and other states return to session next year, Ann Morse, program director of the immigrant policy project at NCSL, said she expected the trend of immigration legislation to continue.
"I don't see any reason for declines in the near future," she said. "What lawmakers are saying is the legislative activity is a way to show the need for federal immigration reform. It's a way to capture attention."
She added that while states will most likely continue to look at laws such as the one passed in Arizona, as well as court cases dealing with the issues, a court decision enjoining portions of the law might cause states to hold back on proposing similar legislation.
Another issue that might cause states to hold back on similar legislation is the current economic status of the state. In tight economic times, Morse said, states will have to decide what the top priorities for their law enforcement budgets will be.
According to the report by NCSL, of the 10 measures passed by Oklahoma recently, more bills dealt with law enforcement than any other subject. Employment and resolutions tied for second place.
Some of the law enforcement legislation listed in NCSL's report includes language from existing statute, specifically language requiring any immigrant unlawfully present under federal immigration law to, upon arrest, submit to DNA testing for law enforcement identification purposes. That language was implemented in 2009.
On the subject of employment, NCSL's report includes bills that contain language from existing statute under the Employment Security Act. The language states that the term "employment" does not include services performed by an individual who is a nonresident alien admitted to the United States to perform agricultural labor.
The NCSL report also listed the following measures related to immigration:
• HB 2983, by Duncan and Sykes, modifies the definition of "terrorism" under the Oklahoma Antiterrorism Act to include acts of violence resulting in damage to property or injury perpetrated to coerce a civilian population or government into granting military or religious demands. It increases from a misdemeanor to a felony an act of biochemical assault and modifies punishment to include imprisonment with the Department of Corrections for up to 20 years and/or a fine of up to $20,000. It also modifies the punishment for a biochemical assault to include imprisonment with the Department of Corrections for a term not to exceed life without parole when the person knows the substance used is toxic or lethal to humans. The CCR adds definitions of "conduct," "financial transaction," "monetary instrument," "proceeds" and "transaction" under the Oklahoma Antiterrorism Act. It adds new language prohibiting a person from using any property known to be the proceeds of an act of terrorism to conduct or attempt to conduct any financial transaction involving the property or transport, transmit or transfer the monetary instrument with the intent to commit an act of terrorism, conceal or disguise the proceeds of an act of terrorism or conceal or disguise the intent to avoid a financial transaction reporting requirement. It creates a felony for violations, punishable by two to 10 years imprisonment with the Department of Corrections and/or a fine of up to $50,000 or an amount equal to twice the dollar amount of each transaction, whichever is greater. The CCR also creates a felony for knowingly or intentionally using a money services business or electronic funds transfer network for any purpose in violation of the Oklahoma Antiterrorism Act. It makes violations punishable by imprisonment with the Department of Corrections for two to 10 years and/or a fine of up to $50,000, or an amount equal to twice the dollar amount of each transaction, whichever is greater. The CCR also changes reference of the Oklahoma Corrupt Organizations Prevention Act to the Oklahoma Racketeer-Influenced and Corrupt Organizations Act. It modifies the definition of "racketeering activity" to include activity relating to illegal aliens, organized voter fraud or terrorism and terrorist activities. The NCSL report states the law "relates to various crimes and punishments in the state of Oklahoma. It defines racketeering activity to include engaging in, attempting to engage in, conspiring to engage in, or soliciting, coercing, or intimidating another person to engage in any conduct which is chargeable or indictable as constituting a felony violation including the unlawful concealing, harboring or sheltering of undocumented immigrants." The bill goes into effect Nov. 1.
• SB 2258, by Sen. Clark Jolley, R-Edmond, and Terrill, creates the Greater Protecting Victims of Human Trafficking Act of 2010. The bill makes it unlawful for any person to intentionally destroy, hide, alter, abscond or keep documentation, including birth certificates, visas, passports, green cards or other documents utilized in the regular course to either verify or legally extend an individual's legal status within the United States for the purpose of trafficking a person. The bill authorizes the attorney general, subject to the availability of funds, to establish an emergency hotline number for victims of human trafficking to call in order to request assistance or rescue. The bill also authorizes the attorney general to enter into agreements with county health departments to require posting of the rights contained in the law and the hotline number for publication in locations as directed by the State Department of Health. The bill also modifies the definition of blackmail to including threatening to report a person as being illegally present in the United States. The NCSL report states the law "declares it unlawful for any person to knowingly shelter, harbor, conceal, transport, move, or attempt to transport to any person unlawfully present in the United States. The law prohibits the destruction of documentation papers to extend an individual's legal status for the purposes of human trafficking. The law also provides support for victims of human trafficking including mandates on providing shelter, medical assistance, food, and legal assistance for victims as needed."
• SB 1280, by Sen. Patrick Anderson, R-Enid, and Rep. Ron Peters, R-Tulsa, modifies the definition of "employment" under the Employment Security Act as it relates to home services as part of a program administered by the Department of Human Services. The bill went into effect July 1.
• SB1699, by Sen. Andrew Rice, D-Oklahoma City, and Rep. Doug Cox, R-Grove, exempts from the requirement of lawful presence in the United States applicants for special volunteer health care licenses that specify that the eligible volunteer shall not receive or have the expectation to receive any payment or compensation, either direct or indirect, for any services rendered in this state. The NCSL report states the law "relates to the Oklahoma Indigent Health Care Act, adding persons not subject to certain verification. It amends the verification of lawful presence to exempt application of special volunteer health care licenses." The bill went into effect in April.
NCSL's report also listed the following resolutions passed by the Legislature:
• HCR 1048, by Rep. Paul Wesselhoft, R-Moore, and Sen. Tom Adelson, D-Tulsa, declares that the Legislature stands with Israel and the Jewish people in their right to live in freedom, free of terrorism in the safe and secure borders of their forefathers. It also congratulates the Nation of Israel on the occasion of the 62nd anniversary of the founding of the nation. According to the NCSL report, Israel has declared that it will be open to the immigration of Jews from all countries of their dispersion.
• SR 97, by Sen. Kenneth Corn, D-Howe, expresses gratitude to Dr. Nguyen Huu Hoat for his service to the Vietnamese community.
Author: Erin Boeckman
Date: 08/13/2010
Attorneys for the State Chamber submitted a request with the court Tuesday to file an amicus curiae, or friend of the court, brief in support of Holland's petition challenging the constitutionality of HB 2437, which creates the Health Carrier Access Payment Revolving Fund, and which is set to take effect later this month. The bill requires all health carriers to pay to the insurance commissioner an access payment of 1 percent on all claims paid beginning from the effective date of the act until Jan. 1, 2015.
"We are asking the Supreme Court to allow us to voice the arguments of Oklahoma's business community against this very costly tax," said Fred Morgan, president and chief executive officer of the State Chamber, in a news release. "The Legislature and the governor's office have estimated that this new tax on health care benefits will raise $78 million. We estimate the cost to Oklahomans to be much higher when you consider the administrative expenses of trying to comply with this very poorly drafted legislation."
The Supreme Court denied that request Thursday afternoon.
In response to the court's action, Morgan issued a statement saying, "While we are disappointed that the Supreme Court turned down our request, we will wait for the Supreme Court's final decision on the lawsuit and will re-examine our options at that time."
HB 2437, by Rep. Doug Cox, R-Grove, and Sen. Mike Johnson, R-Kingfisher, states that the Health Carrier Access Payment Revolving Fund in the State Treasury is to be used by the Oklahoma Health Care Authority to fund the state's Medicaid program and make full use of any federal matching funds available to the state. It requires the insurance commissioner to pay collected funds to the State Treasury weekly. The bill allows the insurance commissioner to refuse to renew, suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in the state of any health carrier failing to pay an access payment. It also allows the commissioner to assess civil penalties and collect reasonable attorney fees if judicial action is necessary for enforcement.
The State Chamber said it concurred with Holland's claims that the legislation was unconstitutional because it was a revenue-raising bill and did not follow the procedure set out in the Oklahoma Constitution for passage of a revenue-raising measure.
Holland's attorneys asked the Supreme Court to assume original jurisdiction over the case. The court has not yet made any decisions on the matter. HB 2437 is set to go into effect on Aug. 26.
Author: Erin Boeckman
Date: 08/12/2010
Holland's petition challenges the constitutionality of HB 2437, which creates the Health Carrier Access Payment Revolving Fund, and which is set to take effect later this month.
On Tuesday, attorneys for the State Chamber filed paperwork with the Oklahoma Supreme Court seeking to file an amicus curiae, or friend of the court, brief in the action.
"We are asking the Supreme Court to allow us to voice the arguments of Oklahoma's business community against this very costly tax," said Fred Morgan, president and chief executive officer of the State Chamber, in a news release. "The Legislature and the governor's office have estimated that this new tax on health care benefits will raise $78 million. We estimate the cost to Oklahomans to be much higher when you consider the administrative expenses of trying to comply with this very poorly drafted legislation."
Both the fee and associated administrative costs will be passed on to businesses, cities, counties, schools and individuals who pay the health insurance premiums, according to the State Chamber's news release.
The legislation in question, by Rep. Doug Cox, R-Grove, and Sen. Mike Johnson, R-Kingfisher, states that the Health Carrier Access Payment Revolving Fund in the State Treasury is to be used by the Oklahoma Health Care Authority to fund the state's Medicaid program and make full use of any federal matching funds available to the state. The bill requires all health carriers to pay to the insurance commissioner an access payment of 1 percent on all claims paid beginning from the effective date of the act until Jan. 1, 2015. It requires the payments to be made to the insurance commissioner monthly on all claims paid and incurred beginning July 1, 2010. It requires the insurance commissioner to pay collected funds to the State Treasury weekly. The bill allows the insurance commissioner to refuse to renew, suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in the state of any health carrier failing to pay an access payment. It also allows the commissioner to assess civil penalties and collect reasonable attorney fees if judicial action is necessary for enforcement.
On Aug. 4, attorneys for Holland and the Oklahoma Health Care Authority, state treasurer and Office of State Finance - respondents in the case - presented oral arguments before a Supreme Court referee. State Chamber Senior Vice President of Operations Mike Seney was present for those arguments, during which Holland's attorney Michael Ridgeway emphasized two main points to his client's contention that HB 2437 was unconstitutional.
First, he argued that HB 2437 is a revenue-raising measure that fell under Article 5, Section 33 of the Oklahoma Constitution. That provision states that revenue-raising bills must receive a three-fourths vote of the House and Senate, which HB 2437 did not receive.
Second, revenue-raising bills cannot be passed during the last five days of session. HB 2437 passed the House on Friday, May 21, prior to the last five days, but it did not pass the Senate until Monday, May 24, which was within the five-day time period. The Legislature adjourned on May 28.
The State Chamber concurs with both arguments, according to its news release.
"There is no doubt that the sole purpose of this legislation is to raise revenue," Morgan said in the news release. "They can call it a fee or an access payment, but it's clearly a tax designed to raise revenue. Moreover, this bill is not even designed to raise money to help the insurance commissioner run her agency. The tax revenues are to be spent for a totally separate purpose.
"While the State Chamber supports the need to find a long-term source of funding for Medicaid, this tax is not it," he added. "We must fight this tax increase with everything we have."
Holland's attorneys also asked the Supreme Court to assume original jurisdiction over the case. The court has not yet made any decisions on the matter. HB 2437 is set to go into effect on Aug. 26.
Author: Erin Boeckman
Date: 08/11/2010
After Bush was first elected governor in 1998, Florida adopted several education reforms, from creation of a voucher program to expansion of charter schools to the grading of individual schools, A through F. Through these reforms, Florida student performance improved.
A version of what Florida did has to be done across the country, Bush told members of the House and Senate gathered in the House chamber. While some may argue over the state of Oklahoma's schools, Bush stressed that there is always room for improvement.
"People argue whether schools are good or lousy, but we have to get past that," he said. "Success is never final. Reform is never complete."
One of the first reforms implemented in Florida was a grading system for schools. Rather than ranking schools as low performing, under performing or high performing, schools are given a grade, A through F just as students are. The grades are based on students' performance on the Florida Comprehensive Assessment Test as well as progress made from one year to the next.
In districts given failing grades, parents are allowed to choose another option for their children. Although an original provision of the reform allowing vouchers for private education was struck down as unconstitutional in 2006, a tax credit program remains in place. The Step Up for Students program provides tax credit scholarships to students in kindergarten through 12th grade from low-income families to allow them to attend private school or another public school.
Funding and additional resources are provided to low-graded schools to improve performance. And, schools that consistently achieve an A grade or improve their grade receive $100 per student more in funding, he said.
"The way to ensure students don't learn is to dumb down the system," Bush said. However, "Raising standards yields higher performance. A system that rewards continuous improvement will yield continuous improvement."
Treatment of teachers also changed under Florida's education reforms. Bush said it was his belief that teaching is a profession, and teachers should be given the development tools they need while also being held to a higher standard. A collegial way of instituting merit pay was through bonuses for teachers, he said.
If Oklahoma is to adopt education reforms like those of Florida, it must appropriate funds to reform first, if that is the priority, Bush explained. In Florida, the state legislature used one-time funds and recurring funds. It also re-allocated funds from the state's education funding formula.
Although reform was given funding priority, money alone is not the answer, Bush emphasized.
"There is no direct link between how much money is spent and student achievement if you look at it objectively," he said. Additional funding alone would yield languishing results. Transformative reforms must be attached to that funding, he said.
Florida enacted its reforms during a time when its per-pupil funding was lower than Oklahoma's, Bush said. The gains in performance were achieved at a funding level below the national average, he said.
Another difference between Oklahoma and Florida lies in the number of school districts. Florida has 67 districts in Florida's 67 counties, while Oklahoma has more than 500 districts. Regardless of the number of districts, Bush said that implementation of a student-centered system with high expectations and a robust accountability system will bring about change.
Although his presentation to legislators only lasted about 45 minutes, Bush emphasized that the reforms he discussed were brought about through 10 years of work and a "royal battle."
"It will be a fight to bring about these changes," he said.
But, the results are showing. The number of Florida students reading at grade level increased, Bush said. Specifically, the state's fourth grade reading scores on the National Assessment of Educational Progress, also referred to as the nation's report card, went from 206 in 1998 to 226 in 2009. The performance of Florida's Hispanic student also improved over that time period. The net result, Bush said, is for Florida's graduation rate to increase and for more students to be college and career ready when they graduate.
The Oklahoma Legislature has already approved some reforms similar to those touted by Bush.
Among other things, SB 2033, by Sen. Glenn Coffee, R-Oklahoma City, and Rep. Chris Benge, R-Tulsa, allows school districts to adopt a salary schedule that provides additional compensation to teachers for achieving certain ratings under the Oklahoma Teacher and Leader Effectiveness Evaluation System. The bill allows a school district to implement an incentive pay plan beginning in the 2012-2013 school year to reward teachers who are increasing student and school growth in achievement.
The measure also modifies language related to a school district board of education's adoption of a written policy of evaluation for teachers and administrators, directing such policies be based upon the Oklahoma Teacher and Leader Effectiveness Evaluation System no later than the 2013-2014 school year. It directs the State Board of Education by Dec. 15, 2011, to adopt a new statewide system of evaluation to be known as the Oklahoma Teacher and Leader Effectiveness Evaluation System and prescribes criteria to be included.
The bill also modifies language related to the definition of "career teacher" and "probationary teacher." It prohibits a principal that has received a rating of "ineffective" under the Oklahoma Teacher and Leader Effectiveness Evaluation System for two consecutive years from being re-employed by the school district, subject to due process procedures. It modifies the Teacher Due Process Act of 1990, directing that a career teacher who has been rated "ineffective" under the evaluation system for two consecutive years shall be dismissed or not re-employed for instructional ineffectiveness, subject to due process. A teacher rated "needs improvement" or lower under the system for three consecutive school years is to be dismissed or not re-employed for instructional ineffectiveness, subject to due process. The measure also states that a career teacher who has not averaged at least an "effective" rating over a five-year period is to be dismissed or not re-employed, subject to due process. The measure also states that a probationary teacher rated "ineffective" for two consecutive school years is to be dismissed or not re-employed, subject to due process, and a probationary teacher who has not attained career teacher status within a four-year period is to be dismissed or not re-employed, subject to due process. The bill also modifies language related to a career teacher's entitlement to a trial de novo, specifying that if a teacher elects to petition for a trial de novo, the teacher must file the petition within 10 days of receipt of notification of the right to a trial de novo from the board of education. It also modifies language related to judgments in such trials.
The bill also directs the State Board of Education to establish a process to identify schools in the state that are consistently listed as persistently low achieving schools under the Elementary and Secondary Education Act of 1965, and it directs the board of education of such schools to adopt one of four intervention models: a turnaround model, a restart model, school closure or a transformation model.
Also, Florida's McKay Scholarships for Students with Disabilities Program is similar to the Lindsey Nicole Henry Scholarships for Students with Disabilities Program Act adopted by the Oklahoma Legislature in 2010.
The program, created by HB 3393, by Rep. Jason Nelson, R-Oklahoma City, and Sen. Patrick Anderson, R-Enid, is designed to provide a scholarship to a private school of choice for students with disabilities for whom an individualized education program, or IEP, has been developed, to be awarded beginning with the 2010-2011 school year. The bill allows a parent or legal guardian of a public school student with a disability to exercise their parental option and request to have a scholarship awarded for the child to enroll in and attend a private school if the student has spent the prior year at a public school and the student has been accepted into a private school eligible for the scholarship program.
The Capitol was only one of Bush's planned stops in Oklahoma. He attended fund-raising events for Congresswoman Mary Fallin, the Republican nominee for governor, and Janet Barresi, who is the Republican nominee for state superintendent.
Author: Bryan Smith
Date: 08/10/2010
Brian King, communications officer for the EBC, said in an interview that the purpose of the meeting was to discuss each of the plans with council members ahead of the next meeting, when the council will make a final decision on providers for 2011.
In June, the council accepted proposals from four health insurance companies: CommunityCare HMO Inc., Blue Cross and Blue Shield of Oklahoma, GlobalHealth Inc. and PacifiCare of Oklahoma Inc. The companies currently provide health insurance coverage for state employees who do not the plan offered by the Oklahoma State and Education Employees Group Insurance Board.
The field of potential providers was narrowed to three before the last meeting on July 27, after Blue Cross and Blue Shield declined to submit a rate plan for review.
At the July meeting, Phil Kraft, EBC executive director, told members that the company had expressed an interest out of belief that it might be possible to be the sole health insurance provider. One provision of SB 2052, which lawmakers approved during the 2010 legislative session, would have required a new board created by the bill to selected only one health maintenance organization to provide state employee health insurance. Gov. Brad Henry, however, vetoed the measure June 11.
King said that one other company, AETNA, also declined to submit a proposal. He said the company had participated in the state employees' health insurance plan for several years.
The council will vote on the proposals on Friday, Aug. 20. The results will help determine rates for the 2011 calendar year.
SB 2052, by Sen. Glenn Coffee, R-Oklahoma City, and Rep. Chris Benge, R-Tulsa, also would have required the Oklahoma State and Education Employees Group Insurance Board to contract for plan year 2011 with a vendor that offers a Web-based, doctor-patient mutual accountability incentive program to work as a pilot program. It listed requirements of the program. It required the program be voluntary to both the provider and patient on an encounter-by-encounter basis. It required the program be offered and administered by the vendor through an Internet application. The bill created the Oklahoma Health and Wellness Board that was to be comprised of 11 members appointed by the governor, the Senate president pro tempore and t House Speaker. The bill also established that a representative of the Oklahoma Education Association and the Oklahoma Public Employees Association would serve as non-voting members of the board. The bill required the board to create and oversee two divisions - the HealthChoice Health Insurance Division and the Employee Benefits Division - for procuring, administering and managing health benefit plans offered to state and education employees. The bill also required the board to consolidate the personnel and facilities of the board and its divisions and to identify inefficient and duplicative functions or services. The bill directed the board to eliminate any duplicative positions or services and to sell or dispose of any duplicative assets. The bill required the board to annually remit to the state treasurer for deposit in the General Revenue Fund an amount that reflects 15 percent of the combined administrative costs of the board as of the end of fiscal year 2010.
The bill also required the board at the end of each plan year to utilize all amounts from the fund equity of the Health and Dental Fund that are in excess of 175 percent of the Experience Fluctuation Risk Component of the National Association of Insurance Commissioners Health Risk-Based Capital calculation for the purpose of funding health savings accounts, flexible spending accounts and the wellness program at the discretion of the board. The bill required the board, at their discretion, to utilize the $5 million Employees Benefits Council surplus for the purpose of funding health savings accounts, flexible spending accounts and the wellness program. The bill required the board to establish a wellness program for all participants in the plan, including financial incentives for participation in the wellness program and health living practices. The bill also required all state employees to participate in the wellness program. The bill specified that the board will choose one health maintenance organization, or HMO, to provide health insurance coverage to state employees. The bill modified the current benefit allowance by specifying that the allowance cannot go lower than Plan Year 2010 amounts and that the benefit allowance would be indexed on the basic preferred provider organization health benefit plan available. The bill provided that any excess benefit allowance for new state employees hired after Nov. 1, 21010,would be deposited in a health savings account, a flexible savings account or deferred compensation account. The bill provided that any new eligible school district employees would use their benefit allowance for health insurance, deferred compensation or Section 125 plan offerings. The bill extended the State Employee Health Insurance Review Working Group for one year and renamed the entity the State Employees Health Insurance and Compensation Review Working Group. The bill repealed sections of law that created the currents boards of OSEEGIB and EBC and several other sections related to EBC that would not be necessary because of the consolidation provided in the bill. The bill amended numerous sections of law to reflect the consolidation of OSEEGIB and EBC to reflect the name change to the Oklahoma Health and Wellness Board.
Author: Erin Boeckman
Date: 08/04/2010
Holland filed a petition against the Health Care Authority, the state treasurer and the Office of State Finance claiming that HB 2437, which creates the Health Carrier Access Payment Revolving Fund, is unconstitutional.
The legislation, by Rep. Doug Cox, R-Grove, and Sen. Mike Johnson, R-Kingfisher, is scheduled to take effect Aug. 26. It states that the Health Carrier Access Payment Revolving Fund in the State Treasury is to be used by the Oklahoma Health Care Authority to fund the state's Medicaid program and make full use of any federal matching funds available to the state. The bill requires all health carriers to pay to the insurance commissioner an access payment of 1 percent on all claims paid beginning from the effective date of the act until Jan. 1, 2015. It requires the payments to be made to the insurance commissioner monthly on all claims paid and incurred beginning July 1, 2010. It requires the insurance commissioner to pay collected funds to the State Treasury weekly. The bill allows the insurance commissioner to refuse to renew, suspend or revoke, after notice and hearing, the certificate of authority to transact insurance in the state of any health carrier failing to pay an access payment. It also allows the commissioner to assess civil penalties and collect reasonable attorney fees if judicial action is necessary for enforcement.
Representing Holland, attorney Michael Ridgeway emphasized his client's argument that "revenue raising" was the only purpose for HB 2437, and therefore it fell under Article 5, Section 33 of the Oklahoma Constitution. That provision states that revenue-raising bills must receive a three-fourths vote of the House and Senate. HB 2437 passed 59 to 33 in the House and 29 to 14 in the Senate. A three-fourths vote would have required 76 votes in the House and 36 votes in the Senate.
Revenue-raising bills also cannot be passed during the last five days of session. HB 2437 passed the House on Friday, May 21, prior to the last five days, but it did not pass the Senate until Monday, May 24, which was within the five-day time period. The Legislature adjourned on May 28.
"The sole purpose of HB 2437 is to raise revenue," Ridgeway said.
Determining whether a bill raises revenue is not the end to determining whether it is constitutional, said Howard Pallotta, general counsel for the Oklahoma Health Care Authority. The Supreme Court has ruled many times before on the constitutionality of statutes, including revenue-raising measures.
For example, in Pure Oil Co. vs. the Oklahoma Tax Commission, Pure Oil contested a tax imposed by the Motor Carrier Act of 1935 because it passed on the last day of the legislative session. However, the Supreme Court ruled in 1936 that the real purpose of the act was to regulate the use of highways, not raise revenue. Pallotta said this supports the Health Care Authority's claim that raising revenue is "incidental" to HB 2437.
Ridgeway countered, however, that if the duties of the insurance commissioner to collect the health carrier access payment were removed, there would be no other substance to the legislation.
Arguments were also made regarding whether the Supreme Court should even assume jurisdiction in the matter.
Ridgeway cited instances in the past when the court had accepted jurisdiction over intergovernmental controversies. He urged the court to take the case and to decide it swiftly to avoid potentially harmful outcomes.
First, Ridgeway said, because the insurance commissioner believes HB 2437 to be unconstitutional, she and the Insurance Department's staff would be acting in violation of their oaths to uphold the Constitution if they had to enforce the legislation's provisions. Second, if the court declined jurisdiction and the matter was forced into the district court system, a resolution would not be reached until after HB 2437 were implemented. If it is declared unconstitutional, costs of administering the legislation will have already been incurred, and refunds may be required if access payments were already made, he said.
Pallotta and Tina Izadi, an assistant attorney general representing the state treasurer's office and the Office of State Finance, argued that the case was not worthy of original jurisdiction by the Supreme Court.
As to Ridgeway's argument for expediency, Izadi said it is not the function of the Supreme Court to assume original jurisdiction for the sake of "practicality" or "efficiency." Second, there is no separation of powers issue. It is the insurance commissioner's duty to assume any statute passed by the Legislature is constitutional, just as the attorney general himself must do when constitutional challenges are brought against other state statutes, she said. Pallotta agreed that it would require a lot of speculation on the part of the court to assume jurisdiction.
The third point raised by Holland's petition is that HB 2437 is preempted by the federal Employee Retirement Income Security Act of 1974, or ERISA, and therefore cannot be enforced by the insurance commissioner, Ridgeway said.
HB 2437 specifically includes third-party administrators, as defined in state statute, under the definition of "health carrier" and subject to the access fee. The Insurance Department has already made attempts to try to identify third party administrators that administer health plans under ERISA, and no such list can be found, Ridgeway said.
Pallotta countered with a New York case in which a court decided that a surcharge fee hospitals were required to collect from health carriers was incidental and did not affect how ERISA plans were operated.
Retired Oklahoma City attorney Jerry Fent also appeared before the Supreme Court referee and offered an amicus curiae, or "friend of the court," brief in support of Holland's case.
Fent's comments focused on Section 5 of HB 2437, which amends current statute regarding the State Insurance Commissioner Revolving Fund, specifically a provision in current law directing 76.5 percent of the funds paid or collected by the insurance commissioner to go to the General Revenue Fund. He argued that HB 2437 was created for the principal purpose of raising money for the General Revenue Fund to balance the budget, not fund Medicaid.
He also agreed with Holland's claim that passage of the legislation would have required a three-fourths vote in both houses of the Legislature outside of the last five days of session.
Both Izadi and Pallotta argued that Fent's amicus brief was irrelevant because it raised new arguments. An amicus brief must accept the original case as presented, but he attacks an apportionment of the insurance commissioner's revolving fund, which is not part of Holland's petition, Izadi said. She and Pallotta asked the court to strike the brief.
Supreme Court Referee Barbara Swimley said the case will be submitted to the court for its consideration.
Speaking to reporters after presenting his arguments, Ridgeway said the petitioners will wait to see if the court assumes jurisdiction. He said he hopes a decision comes before HB 2437 goes into effect.
HB 2437 was part of the fiscal year 2011 budget that the Health Care Authority Board has already approved. It was expected to generate around $52 million during the fiscal year. Ridgeway said the court should act swiftly to strike down the legislation to allow the Legislature time to address the loss of funds for the authority.
As for Fent, he will get another chance to make his arguments regarding apportionments to the General Revenue Fund when he appears before the Supreme Court in another case he has brought. He filed suit in May contesting provisions in the Oklahoma Constitution that require self-sustaining boards to pay 10 percent of their licensing fees to the General Revenue Fund.
Author: Shawn Ashley
Date: 08/04/2010
"I'm encouraged by Missouri's numbers and expect Oklahoma to have something similar to that," Newberry, R-Tulsa, said Wednesday, one day after Missouri voters approved Proposition C.
The proposition states that no law or rule shall compel, directly or indirectly, any person, employer or health care provider to participate in any health care system, which amounts to an opt out of certain provisions of the federal Patient Protection and Affordable Care Act. The proposition was approved Tuesday with 71 percent voting in favor of its adoption and 29 percent voting against.
The language in Missouri's proposal is similar to that of SJR 59, by Newberry and Rep. Mike Thompson, R-Oklahoma City, which is scheduled to appear on the November ballot as State Question 756. It also proposes a constitutional amendment prohibiting a law from compelling any person, employer or health care provider from participating in any health care system. The measure also allows a person or employer to pay directly for health care services without being required to pay penalties or fines and allows a health care provider to accept payment for health care services without being required to pay penalties or fines. It prohibits the purchase or sale of health insurance in private health care systems from being prohibited by law or rule, subject to reasonable and necessary rules that do not substantially limit a person's options.
Newberry said, "I think the vote underlines citizens' feelings toward this expansive overreach of the government's authority into health care."
Tuesday's vote made Missouri the first state in the nation to vote on such language. Arizona will join Oklahoma in asking its voters to consider the same question in November.
Newberry said he expects high turnout in Oklahoma this November because of the gubernatorial race, several House and Senate seats up for election and 11 ballot measures. In light of the amount of elections on the ballot, there will be great voter turnout in Oklahoma, he predicted. Missouri's turnout shows the passion the people there felt, he added.
Missouri Secretary of State Robin Carnahan said Wednesday that the unofficial voter turnout for Tuesday's primary election was 22.9 percent with approximately 938,782 of Missouri's 4,104,834 registered voters going to the polls.
Newberry said he has been talking to his constituents and others about the measure.
"Almost unanimously, people I've spoken with have been in support of the ballot measure," he said, adding that he recalled meeting only one person in opposition.
According to a published report, Missouri state Sen. Jane Cunningham, one of the sponsors of that state's proposal, said, "The citizens of the Show-Me State don't want Washington involved in their health care decisions."
She said of the nearly 3-to-1 margin of victory, "I've never seen anything like it. Citizens wanted their voices to be heard."
Newberry agreed, saying that State Question 756 in Oklahoma is a question of the fundamental rights of people having the right to make the best decisions for their families and not having the government penalize them.
"This is a paramount issue we must address," he said.
[Editor's Note: Managing Editor Erin Boeckman contributed to this story.]
Author: Erin Boeckman
Date: 08/03/2010
On the ballot in Missouri Tuesday was Proposition C, which contains a proposal from the Missouri General Assembly, HB 1764, stating that no law or rule shall compel, directly or indirectly, any person, employer or health care provider to participate in any health care system. It essentially proposes an opt-out of certain provisions of the federal Patient Protection and Affordable Care Act.
The language contained in Missouri's proposal is very similar to that of SJR 59, by Sen. Dan Newberry, R-Tulsa, and Rep. Mike Thompson, R-Oklahoma City, which is scheduled to appear on the November ballot as State Question 756. It also proposes a constitutional amendment prohibiting a law from compelling any person, employer or health care provider from participating in any health care system. The measure also allows a person or employer to pay directly for health care services without being required to pay penalties or fines and allows a health care provider to accept payment for health care services without being required to pay penalties or fines. It prohibits the purchase or sale of health insurance in private health care systems from being prohibited by law or rule, subject to reasonable and necessary rules that do not substantially limit a person's options.
According to the website for the Missouri Secretary of State, which oversees that state's elections, "It is estimated this proposal will have no immediate costs or savings to state or local government entities. However, because of the uncertain interaction of the proposal with implementation of the federal Patient Protection and Affordable Care Act, future costs to state governmental entities are unknown."
Predictions of what the vote could mean are mixed. Passage of the measure could signal clear opposition to President Barack Obama's health care reforms, but a defeat of the question could hurt Republican candidates who have campaigned against the health care reforms, according to an Associated Press report. However, the Christian Science Monitor reported that the vote will not produce a "scientific sampling of public opinion" because it occurs on the day of the mid-term primaries, when voter turnout is typically low.
Missouri Secretary of State Robin Carnahan predicted a 24 percent turnout for the Tuesday election, meaning more than 1 million voters would cast ballots, according to a news release from the secretary of state's office. Polls were open from 6 a.m. to 7 p.m.
While Missouri is the first state to see the question put on the ballot, Oklahoma and Arizona voters will be asked the same question in November. Florida was also scheduled to put the opt-out language on the ballot, but the Florida State Supreme Court ruled in late July that its ballot question was inappropriate, and it was removed, according to the National Conference of State Legislatures. Thirty-nine state legislatures considered legislation to limit, alter or oppose selected state or federal actions, including single-payer provisions and mandates that would require the purchase of insurance.
The issue is likely still to fall before the courts.
"It may have some rhetorical or symbolic significance," said Allen Rostron, a constitutional law professor at the University of Missouri-Kansas City, in an Associated Press report. But, "if the federal law is valid, then this [vote] essentially amounts to a non-legally binding expression of dissent by the state of Missouri."
Meanwhile on Monday, Judge Henry Hudson in the U.S. District Court for the Eastern District of Virginia allowed a lawsuit from Virginia's state government challenging the requirement that individuals purchase health insurance to move forward. The suit seeks to invalidate the federal Patient Protection and Affordable Care Act.
Virginia Attorney General Ken Cuccinelli, who brought the suit, said in a news release, "We are pleased that Judge Hudson agreed that Virginia has the standing to move forward with our suit and that our complaint alleged a valid claim.
"This lawsuit is not about health care, it's about our freedom and about standing up and calling on the federal government to follow the ultimate law of the land - the Constitution," he added. "The government cannot draft an unwilling citizen into commerce just so it can regulate him under the Commerce Clause."
A summary judgment hearing in the case is scheduled for Oct. 18.
Author: Shawn Ashley
Date: 07/27/2010
Council members met behind closed doors Tuesday to review the plan proposals that were submitted by CommunityCare HMO Inc., GlobalHealth Inc. and PacifiCare of Oklahoma.
AETNA, which currently participates in the state employees' health insurance plan, previously notified the council it did not intend to submit a proposal this year. CommunityCare HMO Inc., GlobalHealth Inc. and PacifiCare of Oklahoma currently provide health insurance plans to state employees.
Blue Cross and Blue Shield of Oklahoma, which had participated in the first phase of the selection process, did not submit a rate proposal, Brian King, EBC communications officer, said.
Phil Kraft, EBC executive director, told the council members that the company also had expressed an interest in submitting a proposal in previous years when it believed it might be possible to be the sole health insurance provider. One provision of SB 2052, which lawmakers approved during the 2010 legislative session, would have required the new board created by the bill to selected only one health maintenance organization to provide state employee health insurance. Gov. Brad Henry, however, vetoed the measure June 11.
Tuesday's executive session was the next step in the process of developing the health insurance options that will be offered to state employees later this year. Council staff now will negotiate with the firms to set the rates that will be subject to council approval when it meets Aug. 20.
SB 2052, by Sen. Glenn Coffee, R-Oklahoma City, and Rep. Chris Benge, R-Tulsa, also would have required the Oklahoma State and Education Employees Group Insurance Board to contract for plan year 2011 with a vendor that offers a Web-based, doctor-patient mutual accountability incentive program to work as a pilot program. It listed requirements of the program. It required the program be voluntary to both the provider and patient on an encounter-by-encounter basis. It required the program be offered and administered by the vendor through an Internet application. The bill created the Oklahoma Health and Wellness Board that was to be comprised of 11 members appointed by the governor, the Senate president pro tempore and t House Speaker. The bill also established that a representative of the Oklahoma Education Association and the Oklahoma Public Employees Association would serve as non-voting members of the board. The bill required the board to create and oversee two divisions - the HealthChoice Health Insurance Division and the Employee Benefits Division - for procuring, administering and managing health benefit plans offered to state and education employees. The bill also required the board to consolidate the personnel and facilities of the board and its divisions and to identify inefficient and duplicative functions or services. The bill directed the board to eliminate any duplicative positions or services and to sell or dispose of any duplicative assets. The bill required the board to annually remit to the state treasurer for deposit in the General Revenue Fund an amount that reflects 15 percent of the combined administrative costs of the board as of the end of fiscal year 2010.
The bill also required the board at the end of each plan year to utilize all amounts from the fund equity of the Health and Dental Fund that are in excess of 175 percent of the Experience Fluctuation Risk Component of the National Association of Insurance Commissioners Health Risk-Based Capital calculation for the purpose of funding health savings accounts, flexible spending accounts and the wellness program at the discretion of the board. The bill required the board, at their discretion, to utilize the $5 million Employees Benefits Council surplus for the purpose of funding health savings accounts, flexible spending accounts and the wellness program. The bill required the board to establish a wellness program for all participants in the plan, including financial incentives for participation in the wellness program and health living practices. The bill also required all state employees to participate in the wellness program. The bill specified that the board will choose one health maintenance organization, or HMO, to provide health insurance coverage to state employees. The bill modified the current benefit allowance by specifying that the allowance cannot go lower than Plan Year 2010 amounts and that the benefit allowance would be indexed on the basic preferred provider organization health benefit plan available. The bill provided that any excess benefit allowance for new state employees hired after Nov. 1, 21010,would be deposited in a health savings account, a flexible savings account or deferred compensation account. The bill provided that any new eligible school district employees would use their benefit allowance for health insurance, deferred compensation or Section 125 plan offerings. The bill extended the State Employee Health Insurance Review Working Group for one year and renamed the entity the State Employees Health Insurance and Compensation Review Working Group. The bill repealed sections of law that created the currents boards of OSEEGIB and EBC and several other sections related to EBC that would not be necessary because of the consolidation provided in the bill. The bill amended numerous sections of law to reflect the consolidation of OSEEGIB and EBC to reflect the name change to the Oklahoma Health and Wellness Board.
Author: Erin Boeckman
Date: 07/26/2010
Funding for senior nutrition became a rallying cause for some legislators during the 2010 session after the Commission for Human Services, which oversees DHS, decided in 2009 to cut $7.4 million from the program that provides meals to senior citizens. The cut was a result of revenue shortfalls and related budget cuts to state agencies during fiscal year 2010.
In the final days of the 2010 session, members approved HB 2367, by Rep. Scott Martin, R-Norman, Rep. Kenneth Miller, R-Edmond, Sen. Mike Johnson, R-Kingfisher, and Sen. David Myers, R-Ponca City, which directs $5 million appropriated to DHS in enrolled SB 1561, which was the general appropriations bill, to be used to fund the state over-match in the congregate and home-delivered meals of the senior nutrition program. It states that the appropriation is to be used exclusively for that purpose.
In determining how to allocate those funds to the state's 11 area agencies on aging, which provide meals to senior citizens through more than 200 locations across the state, DHS asked the agencies to submit action plans with a proposed budget for their portion of the $5 million. All 11 agencies submitted plans by July 20, and they are currently being reviewed by DHS' Aging Services Division, with input from fiscal, programming and other resource experts, according to Mary Leaver, communications manager for DHS.
The review process is scheduled to conclude within two weeks, after which funding approvals will proceed where appropriate, she said.
"There was a great deal of detail requested and a lot of variation in what was submitted, so the [review] team anticipates it will take time to thoroughly review everything," she said in a statement. "The priority will be to get individuals off waiting lists and to restore the full number of serving days."
Areawide Aging Agency, which serves Canadian, Cleveland, Logan and Oklahoma counties, submitted a plan to DHS to restore nutrition services that were devastated by budget cuts, said Don Hudman, executive director of the agency.
Areawide Aging Agency served 45,000 fewer meals last year. Over 10 percent of the agency's meal sites were closed. Home-delivered meals were not being delivered to home-bound people, and the waiting list for such services grew by 200 people, Hudman said.
"We're talking about low-income, vulnerable, elderly people who were not getting meals," he said.
Additionally, budget cuts reduced staffing at the agency, which meant fewer people were available to even check on home-bound people, he said.
"It's one thing to not be able to serve meals, but it's even worse when you can't follow up to see how those folks are," Hudman said.
The plan submitted to DHS by Areawide Aging Agency requests funding to put its system back in place, but it will take more money to get back what the agency lost, Hudman explained. Food costs have increased since cuts were made last year. Service capacity was also lost. Some nutrition programs also did not address needed repairs to equipment because of lack of funding, he said.
Hudman said he and other area agencies on aging are in a holding pattern to see what DHS decides with regard to this year's funding.