Vote Smart's Synopsis:

Vote to pass a bill that establishes a 1% health insurance premium assessment on insurers to fund the Health Care for All Oregon Children Program, and establishes an assessment on hospitals paid by Medicare under a diagnostic related grouping reimbursement mechanism to fund the Oregon Health Plan Standard Program.

Highlights:

-Establishes the Health System Fund in the State Treasury, from which money will be appropriated to fund the Health Care for All Oregon Children Program (Sec. 1). -States that money in the Health System Fund may also be used to provide grants to community health centers and safety net clinics, as well as to pay administrative costs incurred by the department associated with the assessment (Sec. 1). -Requires the Public Employees' Benefit Board to pay an assessment of 1% of all medical claims received as well as the administrative costs associated with the claims received during the calendar quarter (Sec. 3). -Requires insurers to pay an assessment of 1% of the gross amount of premiums earned by the insurer during the calendar quarter that were derived from health plan policies either insuring Oregon residents or delivered/issued for delivery in Oregon (Sec. 5). -Requires a Medicaid managed care organization to pay an assessment of 1% of the gross amount of capitation payments received by the Medicaid managed care organization during that calendar quarter for providing coverage of health services (Sec. 9). -Establishes the Health Care for All Oregon Children Program to provide affordable, accessible health care for all Oregon's children (Sec. 27). This program consists of medical assistance and a private health option administered by the Office of Private Health Partnerships (Sec. 27). -Defines eligibility for the Program as lawful presence in the state by the child, and sets a family income maximum at 200% of the federal poverty guidelines (Sec. 27). -Establishes, by the Department of Human Services, fee-for-service reimbursement rates for inpatient hospital services provided by hospitals that receive Medicare reimbursement on the basis of diagnostic related groups: (1) For the period from October 1, 2009, through September 30, 2013, at the same rate paid by Medicare on the date of the service. (2) For the period beginning October 1, 2013, at a rate that is 70 percent of the rate paid by Medicare on the date of the service (Sec. 29). -Implements, through the Department of Human Services, a simple application process for the medical assistance and premium assistance programs, including an online application submittable via the Internet, application forms readable at the sixth grade level, and application assistance from qualified staff to aid individuals with barriers to applying for medical assistance or premium assistance (Sec. 35).

Full Bill Text

Vote Smart's Synopsis:

Vote to pass a bill that establishes a 1% health insurance premium assessment on insurers to fund the Health Care for All Oregon Children Program; also establishes fee-for-service rates for certain in-patient care programs in hospitals which receive Medicare reimbursements.

Highlights:

-Establishes the Health System Fund in the State Treasury, from which money will be appropriated to fund the Health Care for All Oregon Children Program (Sec. 1). -States that money in the Health System Fund may also be used to provide grants to community health centers and safety net clinics, as well as to pay administrative costs incurred by the department associated with the assessment (Sec. 1). -Requires the Public Employees' Benefit Board to pay an assessment of 1% of all medical claims received as well as the administrative costs associated with the claims received during the calendar quarter (Sec. 3). -Requires insurers to pay an assessment of 1% of the gross amount of premiums earned by the insurer during the calendar quarter that were derived from health plan policies either insuring Oregon residents or delivered/issued for delivery in Oregon (Sec. 5). -Requires a Medicaid managed care organization to pay an assessment of 1% of the gross amount of capitation payments received by the Medicaid managed care organization during that calendar quarter for providing coverage of health services (Sec. 9). -Establishes the Health Care for All Oregon Children Program to provide affordable, accessible health care for all Oregon's children (Sec. 27). This program consists of medical assistance and a private health option administered by the Office of Private Health Partnerships (Sec. 27). -Defines eligibility for the Program as lawful presence in the state by the child, and sets a family income maximum at 200% of the federal poverty guidelines (Sec. 27). -Establishes, by the Department of Human Services, fee-for-service reimbursement rates for inpatient hospital services provided by hospitals that receive Medicare reimbursement on the basis of diagnostic related groups: (1) For the period from October 1, 2009, through September 30, 2013, at the same rate paid by Medicare on the date of the service. (2) For the period beginning October 1, 2013, at a rate that is 70 percent of the rate paid by Medicare on the date of the service (Sec. 29). -Implements, through the Department of Human Services, a simple application process for the medical assistance and premium assistance programs, including an online application submittable via the Internet, application forms readable at the sixth grade level, and application assistance from qualified staff to aid individuals with barriers to applying for medical assistance or premium assistance (Sec. 35).

Full Bill Text