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It_. HEALTH CA RE October 21, 1991 Volume IV, Number 3 Staff Contact: Pat Blankenburg Associate Director, Government Relations GOVERNOR CALLS HEALTH CARE NEWS CONFERENCE Governor Thompson presided over an impressive line-up of bipartisan legislators at an October 18 news conference. Also at hand were Administration Secretary Jim Klauser, Health & Social Services Secretary Jerry Whitbum and top aides from the Office of the Insurance Commissioner. The group rallied around the Govemor's announcement of a proposal to make health insurance more affordable to the state's small businesses, farmers and self-employed individuals by the creation of a basic benefits plan. The proposal is a provision that was deleted from a small business health care initiative when it passed in AB 91, the budget bill. Flanked by Assembly Speaker Walter Kunicki and Minority Leader David Prosser, the Govemor described the proposal, drafted by the Office of the Insurance Commissioner, and legislators expressed support for a teamwork approach in getting the bill passed quickly. The proposal establishes health insurance coverage for f'LrmS of 25 or fewer employees where health insurance has not been offered for the preceding 12 months. Under the bill, insurers offering the plan would be required to make it available to any eligible employer or employee regardless of the individual's or family member's medical history. It is hoped that plans would be priced significantly below the current market. The proposal would allow self-employed individuals to deduct a portion of their health insurance premiums. A 14-member board would be established to develop a benefit proposal and administer the plan. Elements of the Governor's proposal are similar to recommendations developed in the 12-Point Plan for Health Care Cost Containment and those suggested by the Wisconsin Health Care Forum. Speaking briefly at the news conference in support of the small business proposal were Jim Haney, WMC; Bob Taylor, Wisconsin Hospital Association; Tom Adams, State Medical Society; and Bill Smith, National Federation of Independent Business. Haney said, "We are encouraged by the bipartisan nature of this proposal, which will begin to address two of our concerns--access to health care and cost. We look at it as a first step to a more comprehensive package." The Governor called for united efforts in dealing with health care issues in the legislature. He cited the efforts of the Assembly in hiring mediator Howard Bellman to help to bring together the diverse interests and various proposals that are being weighed. Bellman is a nationally known mediation expert and a former secretary of the Wisconsin Department of Industry, Labor and Human Relations. In addition to Kunicki and Prosser, Representatives Ben Brancel, Tom Hauke, Peggy Rosenzweig and Greg Underheim will be active in advancing the Governor's proposal. Senators that appear to be taking t_he lead on health care issues are Gerald Van Sistine and Rod Moen. Wisconsin Manufacturers & Commerc~ 501 E Washington Ave., P.O. Box 352, Madison. WI 53701:608/258-3400 FAX: 6081258-3413 T!28702883

Page 2 ~ ~TI~I CARE PROPOSALS B__u_dget BiJ1 AB 91 - Small Business Health Care Initiative. Passed in the Budget Bill, this proposal called for limiting insurance rates and rate increases, as well as prohibiting cancellation of insurance policies due to the health status of individuals within a group. The small business basic benefit plan announced last week is the second part of this initiative. The proposals are based on two of the recommendations contained in the 12-Point Plan for Cost Containment. ~ - Introduced by Rep. Peggy Rosenzweig, the bill also is aimed at assisting small businesses through tax credits and health insurance reform. _.AB__5_,55 - Introduced by Rep. David Clarenbach, this proposal is Wisconsin's version of a universal health plan with a model that would merge all components of health care and administer the plan through a state single-payer system. It would provide health care to all Wisconsin citizens in lieu of private health insurance. Funding would come through a combination of individual and corporate taxes, as well as diverting monies from existing state and federal programs. The proposal has the support of the Coalition for Wisconsin Health, the Center for Public Representation and others. A hearing is scheduled on AB 555 by the Assembly Reform of Health Insurance committee at ~ Saturday. October 26. at the Madison Senior Center. The 12-Point Plan - A consensus package was developed early this year by Wisconsin Manufacturers & Commerce, the Wisconsin Hospital Association, the State Medical Society of Wisconsin, the Association of Wisconsin liMOs and the Wisconsin Association of Life & Health Insurers. Known as the 12-Point Plan, it calls for legislative and a&ninistrative initiatives, as well as steps that individual employers can take to control health care costs. The legislative components of the 12 Point Plan are being drafted in a bill that will be introduced before the end of the October floor period. The plan represents the only comprehensive health care cost contairmaent initiative currently before the legislature. Specifically, the 12-Point Plan calls for: o creation of a process for community involvement in decisions to expand health care facilities or services, o expansion of current cost and quality data collection activities, o adequate funding for existing government programs, o changes in insurance regulation aimed at making health insurance more affordable for small bush~ess, o medical malpractice reform, o elimination of impedhnents to consolidation and mergers among providers, o a rural health care initiative, o expanded health care access for the uninsured, and o establishment of a moratorium on new psychiatric and AODA beds. Wisconsin Health Care Forum Access Plan - The Wisconsin Health Care Forum is a coalition of statewide organizations including WMC, the National Federation of Independent Business, the State Medical Society of Wisconsin, the Wisconsin Hospital Association, the insurance industry and others. T!28702884

Page 3 The Forum has developed a comprehensive plan aimed at expanding access to basic health care services for approximately 70% of the currently uninsured. The subgroups of the population that would be assisted by the Forum plan are the full-time employed, the part-time employed, pregnant women and infants, the short-term unemployed, the long-term unemployed and those who voluntarily choose to be uninsured. The Forum package is being drafted and is scheduled to be introduced as a comprehensive package before the end of the October floor period. Individual components of the Forum proposal, specifically the basic benefit plan for small employers, have been introduced as separate legislation that is likely to be adopted by the end of the session. An additional proposal to create a type of statewide health mahatenance organization has been developed by Ralph Andreano through a coalition effort led by Morris Andrews. The Andre.ano reco~mnendations were reviewed recently and coalition members are meeting to officially respond to the proposal this week. Other proposals that may appear include a state benefits plan that was introduced during the last legislative session by Rep. Louis Fortis, who may reintroduce it. Representative John Antaramian has announced that he will introduce legislation to expand the state's Healthy Start program, increasing medical assistance eligibility to age 9 for children and to 175% of the poverty line. RURAL ISSUF~ FORUM Rural legislators turned out for a health care breakfast forum on October 16 to hear Fred Moskol, UW rural health advocate, and Tim Size, Rural Wisconsin Hospital Cooperative, discuss the critical health care issues for rural areas. Their interests focus on establishing Rural Medical Centers (RMCs) to better serve the needs of unique communities and providing incentives for health professionals to locate in those areas. Rep. Tim Carpenter, Chair of the Assembly Committee on Health, is expected to name a special panel to study rural health concerns. HEALTH & SOCIAL SI~VICES Office of Health Care Information (OHCI) - Phase 5 rules had a hearing on October 15 and are scheduled to take effect on April 1, 1992, by which date the Wisconsin Statutes require the collection of charge information from health care providers other than hospitals and t~reestanding ambulatory surgery centers. The OHCI can collect charge data directly from individual health care providers, but will also review existing databases for sources of charge data. A copy of the Phase 5 rules is available upon request to WMC. _Div.i.~_of Health - In early October, the Division of Health was awarded a $6.5 million seven-year contract by the National Cancer Institute for the American Stop Smoking Intervention Study (ASSIST) for cancer prevention. Wisconsin is one of 17 states to receiving funding. ASSIST Wisconsin is a collaborative effort between the Division of Health, the National Cancer Institute and the Wisconsin Division of the American Cancer Society. WMC joined a number of organizations in support of the grant. I~I&SS Grant App~ - The Division of Health, Center for Health Statistics, has applied to the Robert Wood Johnson Foundation for a grant to develop a Data User Model for Continuous Health System Improvement. Support for the grant application comes from six state agencies, the legislature and a broad range of health care provider and other groups, including WMC. The project would involve working groups within the Agency's bureaus and divisions and regional health offices. Evaluators of the application held a site visit in mid-October. TI28702885

Page 4 Farewell to the Kaufrnan~ - H&SS and Wisconsin will lose two long-time health care advocates this fall when the Kaufmans move to New Jersey. Ira, Chief of the Health Data Analysis Section, Health Statistics, will be teaching and working in health statistics at medical facilities connected with Rutgers University. Nancy, Deputy Director, Bureau of Community Health and Prevention, will become a vice president at the Robert Wood Johnson Foundation. We wish them well. IIEALT[-I CARE ~ DISCUSSION GROUP = QUALITY DATA TASK FORCE More than a year ago, WMC invited organizations to form the Health Care Cost Discussion Group, which developed the 12-Point Plan for Health Care Cost Containment. Poh~t 12 calls for continued efforts to identify public policy and private sector initiatives aimed at controlling costs and improving the delivery of health care in Wisconsin. Another of the points recommends that the Office of Health Care Information (OHCI) identify or develop valid outcome measures and other methodologies for assessing quality. In the spirit of carrying out these two points of the 12-Point Plan, a Task Force was formed to gather aud evaluate various existing data systems that are currently being used to measure quality. A prelintinary report has been made on the findings of the Task Force and recommendations are expected to be presented soon. Information will be presented this week at the WMC Conference on Managing Health Care Costs, CHILD CARE IN THE WORKPLACE WMC held its third conference in September on workplace child care issues--balancing work and family. The conference was held at the newly-opened child care facility at Johnson Wax's Armstrong Park site. On D¢c¢rnber 3, Lt. Governor Scott McCallum will hold his annual recognition luncheon honoring outstanding models of child care/workplace programs. Additional information about nominating a company or attending the recognition lunch is available by calling Mike Friedlande[, 608-267-6915. 6~9 "ON l!tUJad IA~ 'uos!pel~ fllYd aSelSOcl "S'fl ale~i llntl LOGES IkA "uos!pe,,,v ZS£ xofl "O'd "a^V uo~u!qseN~ "3 lOS aa~atumo~ ~, s~mnlam,.nut, lN Ti28702886