1997 - 1998 LEGISLATURE
March 26, 1998 - Introduced by Representatives Baldwin and Bock, cosponsored
by Senators Chvala and Risser. Referred to Committee on Health.
AB955,1,6
1An Act to amend 15.01 (4) and 59.17 (2) (c); and
to create 15.07 (1) (a) 7., 15.07
2(2) (h), 15.07 (5) (m), 15.07 (5m) (c), 15.20, 15.207, 20.430, chapter 52, 59.53 (24)
3and 62.09 (8) (cm) of the statutes;
relating to: establishing a single-payer,
4publicly financed health care system for residents of this state, creating the
5department of health planning and finance, health policy board and regional
6health councils and establishing duties of the health policy board.
Analysis by the Legislative Reference Bureau
Under current law, payment for medical services received by residents of this
state is made from a combination of federal moneys (such as under the medicare,
medicaid and various block grant programs), general purpose revenues (such as the
"state share" of the joint federal-state medical assistance program, state
contributions to relief block grants for health care services and moneys appropriated
for specific medical purposes, such as cancer control grants), local moneys (such as
funding for medical relief health care services and county nursing homes and
hospitals) and private health insurance coverage purchased by individuals or
provided, in part, as employe benefits.
This bill establishes a universal health plan for Wisconsin, effective July 1,
2001, under which each state resident shall, with certain exceptions, receive
reasonable medical services necessary to maintain health, enable diagnosis or
provide treatment or rehabilitation for an injury, disability or disease.
This bill creates a department of health planning and finance that is directed
and supervised by an 11-member health policy board that is also created in the bill.
The bill also creates 6 regional health councils that are attached to the department
of health planning and finance and that report quarterly to the health policy board
on the health care needs, problems and concerns of the region. The bill requires
appropriation of general purpose revenues to the department of health planning and
finance for operation of the health policy board for fiscal year 1997-98 and 1998-99
and requires that the health policy board consider numerous issues related to the
formation of a universal health plan in this state. The board is required to meet
semimonthly beginning on January 1, 1999, to formulate decisions on these issues,
including those raised in reports to the board by the regional health councils, and to
convey these decisions to and cooperate with the legislative reference bureau in the
drafting of proposed legislation for introduction in the legislature on or before
January 11, 2000. The legislative reference bureau must prepare the proposed
legislation that relates to the board's decisions in proper form for introduction.
For further information see the state fiscal estimate, which will be printed as
an appendix to this bill.
The people of the state of Wisconsin, represented in senate and assembly, do
enact as follows:
AB955, s. 1
1Section
1. 15.01 (4) of the statutes is amended to read:
AB955,2,112
15.01
(4) "Council" means a part-time body appointed to function on a
3continuing basis for the study, and recommendation of solutions and policy
4alternatives, of the problems arising in a specified functional area of state
5government, except the Milwaukee river revitalization council has the powers and
6duties specified in s. 23.18, the council on physical disabilities has the powers and
7duties specified in s. 46.29 (1) and (2), the state council on alcohol and other drug
8abuse has the powers and duties specified in s. 14.24
, the regional health councils
9have the powers and duties specified in s. 52.30 (1) and, before January 1, 2001, the
10council on health care fraud and abuse has the powers and duties specified in s.
11146.36.
AB955, s. 2
12Section
2. 15.07 (1) (a) 7. of the statutes is created to read:
AB955,3,2
115.07
(1) (a) 7. Members of the health policy board appointed under s. 15.20 (1)
2(a) shall be appointed as provided in that section.
AB955, s. 3
3Section
3. 15.07 (2) (h) of the statutes is created to read:
AB955,3,54
15.07
(2) (h) The chairperson of the health policy board shall serve for a period
5of 3 years.
AB955, s. 4
6Section
4. 15.07 (5) (m) of the statutes is created to read:
AB955,3,77
15.07
(5) (m) Voting members of the health policy board, $50 per day.
AB955, s. 5
8Section
5. 15.07 (5m) (c) of the statutes is created to read:
AB955,3,129
15.07
(5m) (c)
Health policy board. Members of the health policy board may
10be reimbursed for lost wages if required by their employers to use leave without pay
11in order to attend meetings of the health policy board, and they may be reimbursed
12for actual and necessary child care expenses without proof of financial hardship.
AB955, s. 6
13Section
6. 15.20 of the statutes is created to read:
AB955,3,19
1415.20 Department of health planning and finance. (1) There is created
15a department of health planning and finance under the direction and supervision of
16the health policy board. The health policy board shall consist of the following
17members, each of whom is to serve for a 6-year term and, if reappointed, for an
18additional 6-year term and none of whom may be a health care service provider or
19administrator of a health care facility or organization:
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(a) One member appointed by and from the current membership of each of 6
21regional health councils as specified under s. 15.207 (1) (b).
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(b) Five members, appointed by the governor, who reflect as much as possible
23a balance of gender, race, age and the interests of management, labor and disabled
24individuals.
AB955, s. 7
25Section
7. 15.207 of the statutes is created to read:
AB955,4,4
115.207 Same; councils. (1)
Regional health councils. (a) There are created
26 regional health councils that are attached to the department of health planning
3and finance under s. 15.03, one of which is established in each of the following areas
4of this state:
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1. The northern region, consisting of Ashland, Bayfield, Douglas, Florence,
6Forest, Iron, Langlade, Lincoln, Marathon, Oneida, Portage, Price, Sawyer, Taylor,
7Vilas and Wood counties.
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2. The southern region, consisting of Adams, Columbia, Crawford, Dane,
9Dodge, Grant, Green, Iowa, Jefferson, Juneau, Lafayette, Richland, Rock, Sauk and
10Vernon counties.
AB955,4,1311
3. The western region, consisting of Barron, Burnett, Buffalo, Chippewa,
12Clark, Dunn, Eau Claire, Jackson, La Crosse, Monroe, Pepin, Pierce, Polk, Rusk, St.
13Croix, Trempealeau and Washburn counties.
AB955,4,1614
4. The northeastern region, consisting of Brown, Calumet, Door, Fond du Lac,
15Green Lake, Kewaunee, Manitowoc, Marinette, Marquette, Menominee, Oconto,
16Outagamie, Shawano, Sheboygan, Waupaca, Waushara and Winnebago counties.
AB955,4,1817
5. The southeastern region, consisting of Kenosha, Ozaukee, Walworth,
18Washington, Waukesha and Racine counties.
AB955,4,1919
6. The area within Milwaukee County.
AB955,4,2120
(b) Each regional council shall consist of the following members, to serve for
213-year terms:
AB955,4,2422
1. In the northern region, a total of 16 members, consisting of one member from
23each county in that region. The county board of supervisors of each county in that
24region shall appoint the member from that county.
AB955,5,3
12. In the southern region, a total of 15 members, consisting of one member from
2each county in that region. The county board of supervisors of each county in that
3region shall appoint the member from that county.
AB955,5,64
3. In the western region, a total of 17 members, consisting of one member from
5each county in that region. The county board of supervisors of each county in that
6region shall appoint the member from that county.
AB955,5,97
4. In the northeastern region, a total of 17 members, consisting of one member
8from each county in that region. The county board of supervisors of each county in
9that region shall appoint the member from that county.
AB955,5,1210
5. In the southeastern region, a total of 12 members, consisting of 2 members
11from each county in that region. The county board of supervisors of each county in
12that region shall appoint the 2 members from that county.
AB955,5,1713
6. In the area within Milwaukee County, a total of 12 members, consisting of
146 members who are residents of the city of Milwaukee and are appointed by the
15mayor of the city of Milwaukee, and 6 members who are residents of Milwaukee
16County but are not residents of the city of Milwaukee and are appointed by the
17county executive of Milwaukee County.
AB955, s. 8
18Section
8. 20.005 (3) (schedule) of the statutes: at the appropriate place, insert
19the following amounts for the purposes indicated:
-
See PDF for table ![PDF](https://docs.legis.wisconsin.gov/assets/image/file_acrobat.gif)
AB955, s. 9
1Section
9. 20.430 of the statutes is created to read:
AB955,6,4
220.430 Health planning and finance, department of. There is
3appropriated to the department of health planning and finance for the following
4programs:
AB955,6,6
5(1) Health policy board. (a)
General program operations. The amounts in the
6schedule for the general program operations of the health policy board.
AB955, s. 10
7Section
10. Chapter 52 of the statutes is created to read:
AB955,6,98
Chapter 52
9
Universal health plan
AB955,6,10
1052.01 Definitions. In this chapter:
AB955,6,11
11(1) "Block grant" has the meaning given in s. 16.54 (2) (a) 3.
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12(2) "Board" means the health policy board.
AB955,6,13
13(3) "Department" means the department of health planning and finance.
AB955,6,14
14(4) "Disability insurance policy" has the meaning given in s. 632.895 (1) (a).
AB955,6,16
15(5) "Medicare" means coverage under part A or part B of Title XVIII of the
16federal social security act,
42 USC 1395 to
1395ddd.
AB955,6,17
17(6) "Resident" means an individual who lives or is employed within this state.
AB955,6,23
1852.10 Universal health plan. There is created a universal health plan in this
19state, under which each resident shall receive reasonable medical service necessary
20to maintain health, enable diagnosis or provide treatment or rehabilitation for an
21injury, disability or disease, paid for by a single payer, except that no coverage is
22provided for orthodontia for persons who are age 18 or older that is not medically
23necessary or for the performance of cosmetic surgery.
AB955,7,3
152.20 Health policy board; powers and duties. The board shall consider
2and formulate policy on at least all of the following issues with respect to the
3formation of a universal health plan in this state:
AB955,7,7
4(1) Other than premiums, copayments, deductibles or other forms of direct
5payment by patients, the sources of revenues for the administration of the
6department and the board and for financing the payment of medical services that are
7provided to residents under the universal health plan, including all of the following:
AB955,7,138
(a) Use of federal, state and local moneys that fund, as of the effective date of
9this paragraph .... [revisor inserts date], health care services, including medicare,
10medical assistance, health care services under ss. 49.025, 49.027 and 49.029,
11services under the health care program for low-income families under s. 49.665,
12services provided under federal block grants, alcohol and other drug abuse services
13and services provided by local public health agencies.
AB955,7,1814
(b) Imposition of a tax on employers, based on the amount of wages that they
15pay, that generates, in the aggregate, revenues that are at least equal to amounts
16that employers contribute, as of the effective date of this paragraph .... [revisor
17inserts date], for employe health care benefit costs, including the costs of worker's
18compensation attributable to health care for injured employes.
AB955,7,2219
(c) Imposition of a graduated income tax on individuals that generates, in the
20aggregate, revenues that are not greater than expenditures that individuals make,
21as of the effective date of this paragraph .... [revisor inserts date], for health care costs
22for which coverage under disability insurance policies is not obtained.
AB955,7,2523
(d) An indexing of the sources of revenues under this subsection that provides
24for revenue growth that is equivalent to the anticipated growth of health care costs
25under the universal health plan.
AB955,8,3
1(2) The likelihood of and procedures necessary for obtaining waivers to
42 USC
21396 to
1396v or statutory changes to
42 USC 1396 to
1396v in order to effect all of
3the following:
AB955,8,54
(a) Administration of the medical assistance program in this state by the
5department, rather than by the department of health and family services.
AB955,8,76
(b) Use of federal financial participation to fund a portion of the administrative
7costs, after June 30, 2000, of the department.
AB955,8,138
(c) Use of federal financial participation, after June 30, 2001, to fund, under the
9universal health plan, the health care services received by a percentage of the
10residents that corresponds to the percentage of the residents, as determined by the
11board, that is eligible to receive health care services under the medical assistance
12program or under the health care program for low-income families under s. 49.665
13on July 1, 2001.
AB955,8,1514
(d) The formulation of criteria and procedures for payment of out-of-state
15health care costs incurred by residents specified in par. (c).
AB955,8,1716
(e) Use of federal financial participation to fund the scope, or a portion of the
17scope, of medical services to be provided under the universal health plan.
AB955,8,20
18(3) The likelihood of and procedures necessary for obtaining waivers to
42 USC
191395 to
1395ddd or statutory changes to
42 USC 1395 to
1395ddd in order to effect
20all of the following:
AB955,8,2221
(a) Administration of the medicare program in this state by the department,
22rather than by private insurers.
AB955,8,2423(b) Use of federal funds under
42 USC 1395 to
1395ddd to fund a portion of the
24administrative costs, after June 30, 2000, of the department.
AB955,9,3
1(c) Use of federal funds under
42 USC 1395 to
1395ddd to fund, under the
2universal health plan, the health care services received by residents who are eligible
3to receive services under
42 USC 1395 to
1395ddd beginning on July 1, 2001.
AB955,9,54
(d) The formulation of criteria and procedures for payment of out-of-state
5health care costs incurred by residents specified in par. (c).
AB955,9,86(e) Use of federal funds under
42 USC 1395 to
1395ddd to fund the scope, or
7a portion of the scope, of medical services to be provided under the universal health
8plan.
AB955,9,109
(f) The assignment to the state, as represented by the department, of rights of
10an individual to payment for medical care from any 3rd party.
AB955,9,15
11(4) The likelihood of and procedures necessary for obtaining waivers or
12statutory changes to federal laws, other than those specified in subs. (2) and (3), in
13order to use moneys available under those federal laws for payment of health care
14services or mental health services under the universal health plan or in order to
15provide services to all residents under the universal health plan.
AB955,9,17
16(5) The establishment and maintenance of a health trust fund in the
17department, for receipt of revenues for the purposes specified in sub. (1).
AB955,9,20
18(6) The scope of health care services and other benefits, if any, that shall be
19required to be provided under the universal health plan, including all of the
20following:
AB955,9,2321
(a) Services of all persons licensed, certified, registered or permitted to treat
22the sick under chs. 441, 446, 447, 448, 449, 450, 451, 455 and 459 and services of
23professional counselors and marriage and family therapists under ch. 457.
AB955,9,2524
(b) Health care and mental health treatment services provided by facilities or
25services governed under ss. 45.365, 46.03 (1), 49.70, 49.72 (1), 50.02, 50.03, 50.033,
150.034, 50.32 to 50.39, 50.49, 50.50, 50.91, 51.038, 51.08, 51.09, 58.05, 58.06, 251.05,
2252.073, 252.076, 252.10 and 301.02 and the offices and clinics of persons licensed,
3certified, registered or permitted to treat the sick under chs. 441, 446, 447, 448, 449,
4450, 451, 455 and 459.
AB955,10,55
(c) Services provided by social workers certified under ch. 457.
AB955,10,66
(d) Preventive health care services and health promotional programs.
AB955,10,97
(e) Long-term care and services provided in institutional and
8community-based settings as convalescent or custodial care or care for a chronic
9condition or terminal illness.
AB955,10,1010
(f) Eyeglasses and contact lenses.
AB955,10,1111
(g) Hearing aids, as defined in s. 459.01 (2).
AB955,10,1212
(h) Prescription drugs, as defined in s. 450.01 (20).