The Missouri Senate on Wednesday voted to approve legislation (SB 577) that would create by 2013 a managed care health insurance program called HealthNet to replace the state's Medicaid program, the Kansas City Star reports. The bill would move the state's more than 800,000 Medicaid beneficiaries into one of three groups. In the first group, which would be used mostly in urban areas with many providers and patients, medical providers would receive a per-patient fee. In the second group, Medicaid would pay providers a fee for each service rendered to patients and would be used mostly in rural areas. The final group would include patients with chronic diseases, such as diabetes. Under the legislation, each beneficiary would be assigned a primary care physician and a health care advocate, who would work with patients to develop plans of care and to make healthy lifestyle choices. HealthNet would provide monetary incentives to physicians and hospitals that provide quality care and bonuses to patients who have healthy lifestyles. In addition, the bill would use state and matching federal funds to provide subsidies for health insurance premiums to state residents with annual incomes up to 200% of the federal poverty level. State Sen. Charlie Shields (R), who designed HealthNet, said the plan would improve the health of lower-income state residents while helping the working poor afford health insurance premiums. Missouri Democrats criticized the plan for not expanding eligibility and for not restoring some benefits such as dental coverage, available before cuts were made to Medicaid in 2005 (Wagar, Kansas City Star, 4/12).

Small Businesses
In related news, the Missouri House on Tuesday gave preliminary approval to a bill (HB 818) that would allow businesses with fewer than 50 employees and their workers to pay health insurance premiums with pre-tax dollars, the Star reports. The bill would permit small companies to control health costs by allowing them to set a dollar amount per worker rather than a percentage, according to state Rep. Doug Ervin (R). It also would allow workers to keep the policies if they change employers. In addition, the plan eases enrollment requirements for the state's high-risk insurance pool and sets the maximum price of a high-risk policy at 135% of the market price for a similar policy for a healthy person, as compared to its current level of 170%. The bill also would allow about 6,000 state residents who are unemployed because of changes in free-trade laws to save money on health insurance. Critics said the bill "might help a few fragments of various markets but [would] do little to help employers afford health insurance," the Star reports (Wagar, Kansas City Star, 4/11).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.