EXECUTIVE ORDER
06-45

WHEREAS, the increasing cost of health care presents a tremendous obstacle for Missourians attempting to obtain access to affordable health care coverage; and

WHEREAS, there have been continued reports that private employers have found it increasingly difficult to provide adequate and affordable health care benefits for their employees; and

WHEREAS, the process of finding ways to expand options for affordable health care coverage to more Missourians requires a better understanding of the population that is unable to obtain this coverage on their own and must rely on state-funded health care programs; and

WHEREAS, acquiring quality data about this population is critical to ensuring that sound decisions can be reached about the ways to expand affordable health care options to Missourians; and

WHEREAS, taxpayers would be better served if the state implemented a procedure to facilitate statistical analysis of Missouri employees' health care and participation in taxpayer subsidized health care plans, specifically Medicaid.

NOW, THEREFORE, I, MATT BLUNT, GOVERNOR OF THE STATE OF MISSOURI, by virtue of the authority vested in me by the constitution and the laws of the State of Missouri hereby direct the Department of Social Services to prepare a Medicaid beneficiary employer report to be submitted to the governor on a quarterly basis. Such report shall be known as the Missouri Health Care Responsibility Report.

WHEREAS, taxpayers would be better served if the state implemented a procedure to facilitate statistical analysis of Missouri employees' health care and participation in taxpayer subsidized health care plans, specifically Medicaid.

NOW, THEREFORE, I, MATT BLUNT, GOVERNOR OF THE STATE OF MISSOURI, by virtue of the authority vested in me by the constitution and the laws of the State of Missouri hereby direct the Department of Social Services to prepare a Medicaid beneficiary employer report to be submitted to the governor on a quarterly basis. Such report shall be known as the Missouri Health Care Responsibility Report.

For the purposes of this executive order, a "Medicaid beneficiary" shall mean a person who receives medical assistance from the State of Missouri under chapter 208, RSMo or Titles XIX or XXI of the federal Social Security Act, as amended.

To aid in the preparation of the Missouri Health Care Responsibility Report, the Department of Social Services shall implement policies and procedures to acquire information required by the Missouri Health Care Responsibility Report. Such information sources may include, but are not limited to the following:

1. Information required at the time of Medicaid application or during the yearly reverification process;
2. Information that is accumulated from a vendor the State of Missouri contracts with to identify available insurance;
3. Information that is voluntarily submitted by Missouri employers.

The Missouri Health Care Responsibility Report shall provide the following information for each employer who has fifty or more employees that are a Medicaid beneficiary, the spouse of a Medicaid beneficiary, or a custodial parent of a Medicaid beneficiary:

1. The name of the qualified employer;
2. The number of employees who are either Medicaid beneficiaries or are a financially responsible spouse or custodial parent of a Medicaid beneficiary under Title XIX of the federal Social Security Act, listed as a percentage of the qualified employer's Missouri workforce;
3. The number of employees who are either Medicaid beneficiaries or are a financially responsible spouse or custodial parent of a Medicaid beneficiary under Title XXI of the federal Social Security Act (SCHIP), listed as a percentage of the qualified employer's Missouri workforce;
4. For each employer, the number of employees who are Medicaid beneficiaries, the number of employees who are a financially responsible spouse or custodial parent of a Medicaid beneficiary and the number of Medicaid beneficiaries who are a spouse or a minor child (under age 19) of an employee under Title XIX of the federal Social Security Act;
5. For each employer, the number of employees who are Medicaid beneficiaries, the number of employees who are a financially responsible spouse or custodial parent of a Medicaid beneficiary and the number of Medicaid beneficiaries who are a spouse or a minor child (under age 19) of an employee under Title XXI of the federal Social Security Act;
6. Whether the reported Medicaid beneficiaries are full-time or part-time employees;
7. Information on whether the employer offers health insurance benefits to full time and part time employees, their spouses, and their dependents;
8. Information on whether employees receive health insurance benefits through the company when Medicaid pays some or all of the premiums for such health insurance benefits;
9. The cost to the State of Missouri of providing Medicaid benefits for the employer's employees and enrolled dependents listed as total cost and per capita cost;
10. The report shall make industry wide comparisons by sorting employers into industry categories based on available information from the Department of Economic Development.

If it is determined that a Medicaid beneficiary has more than one employer, the Department of Social Services shall count the beneficiary as a portion of one person for each employer for purposes of this report.

The Missouri Health Care Responsibility Report shall be issued 120 days after the end of each calendar quarter, starting with the first calendar quarter of 2008. The report shall be made available for public viewing on the Department of Social Services web site. Any member of the public shall have the right to request and receive a printed copy of the report published under this executive order through the Department of Social Services.

IN WITNESS WHEREOF, I have hereunto set my hand and caused to be affixed the Great Seal of the State of Missouri, in the City of Jefferson, on this 27th day of November, 2006.

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