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Draft Ohio Constitutional Amendment

Ohio Health Care Uniform Pricing, Limits on Insurance Operator Administrative Costs and Profits, Ohio Medicare for All System

CONTENT AND OPERATION

Creation of the Ohio Health Care Uniform Pricing Board, Limits on Insurance Operator Administrative Costs and Profits, and Ohio Medicare for All Program

The amendment creates the Ohio Health Care Uniform Pricing Board to administer a system of fair and consistent pricing for medical services provided in Ohio, requires that health insurance companies spend 95% of total premiums received on claims, and requires the Ohio General Assembly to create an Ohio Medicare for All system to make affordable health insurance available to all Ohio citizens within 5 years. 

Creation and Operation of the Ohio Health Care Uniform Pricing Board (UPB)

The UPB shall consist of eleven members.  Two members shall be elected from each of the five Ohio Health Department Districts. The Ohio Health Director shall be a voting ex officio member of this Ohio Health Care Board.

A UPB member shall be elected to each of two separate, at large, non-partisan offices in each District.  In the first Ohio primary election after passage of this amendment, Ohio citizens may file for the office in the same manner as for the Ohio House.  Initially, one office in each District shall be for a term of 1 year and the other for 2 years.  Subsequently, the terms of all Board members shall be two years.  The two candidates receiving the most votes in the primary will compete in the next general election for each office.

The UPB will hire and oversee a council of medical experts who will establish uniform rates for medical services, drugs and associated products based upon reasonable costs following procedures similar to those used in the Medicare system.  Negotiation of drug prices will not be prohibited except as by federal law. These rates will be published and followed by all providers of medical services and products in Ohio.   Consideration will be allowed to cover documented uncompensated medical services provided by medical service providers.  The UPB, supported by the council, will be the arbiter regarding questions of the application of the uniform rates in specific cases and will update the rate structure with service definitions and other changes as needed.  The UPC will establish standard forms and procedures by which health providers will submit charges to insurance companies and to uninsured patients.

The UPB members, serving as full time employees, will additionally monitor the operation of the system within their districts, facilitating efficient and effective operation and identifying any system deficiencies to the UPB.

The compensation of the UPB members, the council of medical experts, and supporting staff shall be established by statute.  This compensation, in total, shall not exceed 2% of the total charges for health services in Ohio.

Limits on Insurance Operator Administrative Costs and Profits

For insurance operations within the state of Ohio, 95% of the total policy premiums collected shall be paid as claims to policy holders.  As necessary to meet that requirement, annual rebates shall be issued to all policy holders as the same percentage of their premiums.

Establishment of an Ohio Medicare for All System (OMAS)

Health care is an essential safeguard of human life and dignity, and there is an obligation for the state to ensure that every resident is able to realize this fundamental right. Within five years of the passage of this amendment, the Governor and General Assembly shall establish by law a system to ensure that every resident of Ohio has access to appropriate health care on a regular basis.  This system shall be patterned after and implement the principles of the U.S. Medicare program.  The UPB established under this amendment shall become the controlling board for OMAS when it is established.