GENERAL ASSEMBLY OF NORTH CAROLINA

SESSION 1993

S	1 

SENATE BILL 1293

Short Title:  Health Care Reform Commn.	(Public)
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Sponsors: Senator Daniel.
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Referred to:  Rules and Operation of the Senate.
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July 5, 1993

A BILL TO BE ENTITLED
AN ACT TO ESTABLISH THE LEADERSHIP COMMISSION ON HEALTH CARE REFORM.
Whereas, the Commission on Access to Health Insurance reported its findings and proposed short-term and long-term health care reform legislation to the 1993 General Assembly; and
Whereas, some health care reform legislation has been ratified by the 1993 General Assembly; and
Whereas, over 30 health care reform bills have been introduced in the 1993 General Assembly; and
Whereas, the 1993 General Assembly has determined that continued study is needed on health care reform; Now, therefore,
The General Assembly of North Carolina enacts:
Section 1.  (a) There is created the Leadership Commission on Health Care Reform.  The Commission shall study the issues involved in designing and developing a health care plan that ensures that all citizens of the State have access to affordable health care and health insurance and that provides coverage for basic health care needs.  In conducting its study, the Commission shall consider:
(1)	The following health care reform bills recommended by the Commission on Access to Health Insurance and introduced in the 1993 General Assembly:
a.	Senate Bill 2 - Managed Competition Act,
b.	Senate Bill 3 - Caring Program Funds,
c.	Senate Bill 4 - Medicaid Coverage/Children,
d.	Senate Bill 5 - Medicaid for Disabled and Elderly,
e.	Senate Bill 6 - Rural/Primary Care Initiatives,
f.	Senate Bill 7 - Uniform Insurance Claims Form,
g.	Senate Bill 8 - No Self-Referrals/Health Care, and
h.	Senate Bill 9 - Hospital Cooperation Act.
(2)	All other health care reform legislation introduced in the 1993 General Assembly, including:
a.	House Bill 4 - Health Care Access,
b.	House Bill 572 - Family Health Care Program,
c.	House Bill 675 - Physician Practice Parameters,
d.	House Bill 729 - Small Employer Health Plans,
e.	House Bill 821 - Health Care Reform Act,
f.	House Bill 941 - Health Care Provider Cooperation Act,
g.	House Bill 1232 - Rural/Primary Care Initiatives,
h.	Senate Bill 41 - Health Care Cost Control,
i.	Senate Bill 42 - Health Benefits Deductibles,
j.	Senate Bill 330 - GPAC/Preventive Health Benefits,
k.	(HCS) Senate Bill 554 - Fletcher-Jeralds Act,
l.	Senate Bill 696 - Small Employer Health Plan,
m.	Senate Bill 722 - Uninsured Health Coverage.
(3)	Health care reform legislation enacted or being considered by the United States Congress.
(b) The Commission shall study and report on the following specific issues:
(1)	Identification of a health care benefit package for all North Carolinians;
(2)	Development of an actuarial study of the benefit package proposed in Senate Bill 2 and House Bill 572, introduced in the 1993 General Assembly, and any other proposed health care benefit package identified by the Commission that proposes covering all North Carolinians;
(3)	Federal, State, local, and private funds currently being spent on the delivery of health care services in North Carolina, including administrative expenditures associated with insurance and third-party insurance administrators;
(4)	Federal, State, local, and private funds currently being spent on the delivery of public health services in North Carolina;
(5)	Federal, State, and local funds currently being spent on the State regulation of health care services;
(6)	The long-term impact of the cost of health care reform on business and industry in North Carolina;
(7)	Rates charged by the health insurance industry in North Carolina.
(c) The Commission shall recommend mechanisms or actions necessary to design, develop, and finance a health care plan to ensure that all citizens of the State have access to affordable health care and health insurance that provides coverage for basic health care needs to the General Assembly, including, but not limited to:
(1)	Mechanisms to assure universal access to needed health care services for all North Carolinians;
(2)	The need for a State Health Commission with broad responsibilities in the proposed health care plan;
(3)	Restructuring of the health care delivery system into community care networks, community health districts, or accountable health plans based upon the following principles:
a.	The ultimate goal should be improved health status, not health care;
b.	Health status must be improved primarily through locally developed initiatives;
c.	The appropriate role of the State is to assure a framework by which health services can be delivered in local communities;
d.	While State and local governments should provide the framework for the delivery of health services, they should not interpret this responsibility as a requirement to directly provide all of the services; and
e.	In order for a new health system to be effective, there must be cooperative and collaborative efforts in place throughout the State. Hospitals, health departments, individual health providers, provider organizations, and others must find new and innovative ways to work together effectively, and laws should be amended or enacted as necessary to encourage these efforts.
(4)	The need for the development of mechanisms to administer and regulate the restructured health delivery system in North Carolina, including managed competition, single payor, or other options;
(5)	Financing of the proposed health care plan; and
(6)	Mechanisms to ensure the delivery of quality health care services in North Carolina.
Sec. 2. The Commission shall consist of 13 members, as follows:
(1)	The Governor;
(2)	The Speaker of the House of Representatives;
(3)	The President Pro Tempore of the Senate;
(4)	Five members appointed by the Speaker of the House of Representatives, one of whom is the chair of the House Appropriations Committee, one of whom is the chair of the House Finance Committee, one of whom is the chair of the House Health and Human Services Committee, and two members of the House of Representatives, one of whom represents the political party to which the largest minority of the membership of the General Assembly belongs;
(5)	Five members appointed by the President Pro Tempore of the Senate, one of whom is the chair of the Senate Appropriations Committee, one of whom is the chair of the Senate Finance Committee, one of whom is the chair of the Senate Children and Human Resources Committee, and two members of the Senate, one of whom represents the political party to which the largest minority of the membership of the General Assembly belongs.
If vacancies occur among the membership appointed under subdivisions (4) and (5) of this section, the vacancies shall be filled by the original appointing authority using the criteria established in those subdivisions.
Sec. 3. The Governor shall chair the Commission.  The chair shall call the first meeting of the Commission within two months of adjournment of the first session of the 1993 General Assembly.  The Commission shall meet at least monthly.
Sec. 4. The Commission members shall receive no salary for their services but shall receive per diem, subsistence, and travel expenses in accordance with the provisions of G.S. 120-3.1.
Sec. 5. The Commission may contract for professional or other services it may require in the course of its study.  Upon the request of the Commission, the Legislative Services Commission may assign professional and clerical staff to assist in the work of the Commission.  The Commission may meet in the Legislative Building or the Legislative Office Building upon the approval of the Legislative Services Commission.
Sec. 6. The Commission shall submit an interim report on or before the first day of the 1993 General Assembly, Regular Session 1994, by filing the report with the President Pro Tempore of the Senate and the Speaker of the House of Representatives.
Sec. 7. The Commission shall submit a final report of its findings and recommendations to the General Assembly on or before the first day of the 1995 Session of the General Assembly by filing the report with the President Pro Tempore of the Senate and the Speaker of the House of Representatives. Upon filing its final report, the Commission shall terminate.
Sec. 8. There is allocated from the funds appropriated to the General Assembly's Legislative Services Commission the sum of fifteen thousand dollars ($15,000) for the 1993-94 fiscal year and the sum of fifteen thousand dollars ($15,000) for the 1994-95 fiscal year for the expenses of the Commission established under Section 1 of this act.
Sec. 9. This act becomes effective July 1, 1993.