Commission weighs how to use $250,000 OIC proviso for actuarial modeling to inform financing and reimbursement

Commission staff told the Universal Health Care Commission on Feb. 12 that an OIC proviso provides $250,000 to support actuarial or economic modeling related to universal-health system design.

Jen Scott (HCA) described the proviso as "$250,000 of the insurance commissioner's regulatory account" that must be spent by June 30, 2027, and said staff envision using the funds to contract for analyses such as those performed by Milliman in 2025. The proposed uses discussed included testing hospital global budgets, administrative-structure costs, rural-provider participation thresholds, revenue-inventory and employer opt-in incentives, and sensitivity testing for reimbursement frameworks.

Commissioners and staff generally recommended the modeling focus on financing and provider reimbursement—areas FTAC and the commission had identified as outstanding design questions—rather than on enrollment infrastructure or governance. Members proposed combining scenarios about administrative simplification ("cutting out the middlemen") with financing scenarios so the analysis can show how changes in administration could free funds to increase primary-care and behavioral-health reimbursement.

Staff agreed to inventory existing state expenditure data (cost-board figures by payer type) and present a narrower proposal for contracting and scope. The staff timeline anticipates developing a proposal and standing up contracting processes while seeking commission feedback on which discrete design element the modeling should address.

No contract award was made at the meeting; commissioners asked staff to return with a targeted scope and a recommendation for how to prioritize use of the proviso funds.