Senate adopts substitute for bill allowing membership "health contracts" for Farm Bureau model

The Missouri Senate on Monday adopted a substitute for Senate Bill 79 and perfected the measure, clearing the way for the proposal to be printed and advance through the legislative process.

Sponsor and supporters said the measure is intended to allow qualified membership organizations — the Missouri Farm Bureau was discussed repeatedly on the floor — to offer membership-based contracts for health-care benefits to their members. The substitute adds consumer-facing requirements, a complaint route to the Department of Commerce and Insurance and a 1 percent fee on claims paid to support oversight.

Senator from Saline, who explained the bill on the floor, said the measure is targeted at people he described as falling into a coverage gap: they earn too much to qualify for marketplace subsidies but not enough to qualify for Medicaid. "Eight percent of Missourians are going without health coverage right now," the senator said during his explanation, and the substitute is modeled in part on longstanding programs run by other state Farm Bureaus.

Why it matters

Senate Bill 79 would not create an insured product governed by the state—s insurance code; instead it defines a contract for health-care benefits that membership organizations may offer to members. Supporters said it offers a lower-cost option for some households that currently go without coverage and that the substitute includes transparency and consumer-protection language the sponsor said was negotiated after discussions with the Department of Commerce and Insurance.

What the bill says and what changed

- Consumer disclosure: The adopted substitute requires a front-page notice to anyone who signs a contract. The bill includes the following text as part of that disclosure: "This contract is not health insurance and is not subject to federal or state laws relating to health insurance. This contract may offer fewer benefits than an…