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1994 SESSION


SENATE JOINT RESOLUTION NO. 132
Requesting the Joint Commission on Health Care, in cooperation with the Bureau of Insurance and other state agencies and private groups, to continue its study of health plan purchasing cooperatives.
Agreed to by the Senate, March 1, 1994
Agreed to by the House of Delegates, February 25, 1994

WHEREAS, a lack of insurance coverage continues to be a major problem in Virginia; and

WHEREAS, the Commonwealth has enacted various programs and policies designed to expand access to health coverage for the uninsured; and

WHEREAS, the Commonwealth makes major expenditures for the purchase of health care coverage for state and local public sector employees; and

WHEREAS, health plan purchasing cooperatives could enable small businesses, individuals, families, and other groups to benefit from the power of large purchasing cooperatives that negotiate and contract with competing partnerships of health care providers and insurers; and

WHEREAS, other states and the U.S. Congress are considering health plan purchasing cooperatives as major elements of health care reform; and

WHEREAS, the Joint Commission on Health Care, in cooperation with the Bureau of Insurance and other state agencies and private groups, has initiated a study of the feasibility of creating health plan purchasing cooperatives to increase access to affordable health care coverage for small businesses, individuals, families, and other groups that would benefit from the economics of cooperative purchasing; and

WHEREAS, the results of this study indicate that there are a number of complex operational issues involved in the creation of health plan purchasing cooperatives; and

WHEREAS, there is a need for additional public discussion and analysis before the General Assembly makes final decisions about the creation of health plan purchasing cooperatives; now, therefore, be it

RESOLVED by the Senate, the House of Delegates concurring, That the Joint Commission on Health Care, in cooperation with the Bureau of Insurance and other state agencies and private groups, continue to study the feasibility of creating health plan purchasing cooperatives. In this regard, the joint commission is requested to make recommendations in the following areas regarding health plan purchasing cooperatives (cooperatives): (i) the potential of cooperatives to expand access to necessary health coverage for the working uninsured, uninsured children, and other uninsured individuals; (ii) the potential of cooperatives to serve state employee benefit plans and the Virginia Medicaid program; (iii) the appropriate employer size threshold; (iv) the appropriate organizational model and governance structure for cooperatives; (v) whether participation in cooperatives should be mandatory or voluntary; (vi) the appropriate role of state employee benefit plans and the Medicaid program; (vii) the appropriate number of cooperatives and the corresponding regional responsibilities; (viii) the appropriate role of cooperatives in setting prices, certifying health plans, and extending access to underserved areas; (ix) the types of plans which should be offered through cooperatives; (x) the appropriate degree of employee and employer cost sharing and choice; (xi) appropriate rating, underwriting, and open enrollment requirements for participating health plans; (xii) the appropriate risk adjustment methodology to be used in cooperatives; (xiii) the appropriate use of private administrators in carrying out the responsibilities of cooperatives; (xiv) the anticipated costs of creating cooperatives; and (xv) the pertinent legal issues surrounding the creation of cooperatives; and, be it

RESOLVED FURTHER, That the Joint Commission on Health Care, in cooperation with the Bureau of Insurance and other state agencies and private organizations, shall: (i) gather information on the target population's interest in and views on purchasing health care through a health plan purchasing cooperative, (ii) identify legislation that may be required for the Commonwealth or other entities to establish health plan purchasing cooperatives, (iii) and report its findings on health plan purchasing cooperatives to the General Assembly as provided in the procedures of the Division of Legislative Automated Systems for the processing of legislative documents.

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