HB 1039 Summary

• Requires all MO HealthNet beneficiaries to receive covered services through managed care plans authorized by the department, with plans resembling commercially available insurance while complying with federal Medicaid requirements.

• Establishes a competitive bidding process for managed care plans using blind bids on capitation rates, with the lowest qualifying bidder guaranteed participation and a minimum of three plans selected statewide.

• Creates three voluntary enrollment options: a high deductible plan with $1,000 deductibles and department-funded medical savings accounts for uninsured adults ages 19-64 below 100% federal poverty level; a co-payment cost-sharing program with prepaid cards for other recipients; and a preventative care incentive program with health care navigators for recipients with chronic conditions.

• Establishes that MO HealthNet recipients cannot receive abortion coverage except when physician certifies in writing that the mother's life would be endangered if the fetus were carried to term.

• Terminates the Missouri Health Insurance Pool effective January 1, 2014, and allows MO HealthNet recipients who elect private insurance coverage to receive a sliding-scale premium subsidy over a period not to exceed two years beginning July 1, 2014.