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May 19, 2007

Health insurance mandates are under-the-radar issue in Salem

From:, OR - May 19, 2007

The Associated Press

SALEM, Ore. (AP) — After the 2005 legislative session, lawmakers hailed a high-profile bill to require insurers to provide full coverage for mental illnesses and drug abuse as perhaps their most significant accomplishment of the session.

This session, a number of other health coverage expansions — or mandates, depending on your perspective — are on the table in Salem, but so far most have been flying under the radar.

Among others, there are proposals to require health insurers to add or increase coverage of bilateral cochlear implants for children, and gastric bypass surgery, prosthetics and orthotic devices and bone mass measurements, family and marital counseling and diagnoses via telemedicine.

The unknown factor, so far, is how much such requirements might drive up the cost of coverage, and that's caused some lawmakers to say they'll vote against any such mandates, no matter how worthy the cause.

"To me, this is the biggest thing running up health insurance costs in Oregon right now," said State Sen. Larry George, R-Sherwood, who cast one of the few dissenting votes this past week on requiring insurers to cover the costs of birth control. "The Legislature puts mandates on these insurance plans, it forces the cost up so high, some employers are going to start dropping coverage."

Other lawmakers, though, say most of the mandates under discussion this session make only modest tweaks to existing coverage requirements, and were worked out with the cooperation of the insurance industry. Rep. Mitch Greenlick, who chairs the House Health Care committee, said most of the bills were "limited, modest and straightforward."

Insurers have mostly remained quiet about the mandate proposals, perhaps because of the can't-fight-city-hall factor: Democrats, who now control both the state House and Senate, tend to favor expanded coverage options.

Still, some issues have raised industry concerns, and could face amendments before the session concludes, said Fawn McNeely, who lobbies for ODS Health Plans. The industry is keeping a particularly close eye on House Bill 2918, which would require coverage for treatment of some pervasive developmental disorders, including autism spectrum disorder, which has been growing rapidly among Oregon children.

The bill passed unanimously in the House, after emotional testimony from several House members whose own children have been diagnosed with autism. The bill could face some challenges in the Senate, McNeely said.

"We would want to see a limit on the scope," McNeely said. "It's a huge expansion of the definition (of developmental disorders)." The bill's scope has broadened too, she said, to take in both children and adults, and the bill would cover both individual and group health plans, making it potentially very expensive.

But backers said that without such a bill, families could find that a child diagnosed with autism is denied coverage for speech therapy, for example, while the same service for an undiagnosed sibling would be covered.

"We are seeking to get children, or individuals, access to the same level of care that a child without a disability is able to access," said Kathryn Weit, a policy analyst for the Oregon Developmental Disabilities Council whose own child is autistic.

Greenlick, who has spent his career in the health industry and works at Oregon Health & Science University, also hails another bill that's passed the House and is scheduled for a Senate hearing this week. It is designed to give more transparency to coverage costs.

House Bill 2213, he said, would allow Oregonians to call up their insurance companies, tell them they are having any one of a range of basic surgeries, and get a definitive answer on how much they will have to pay out of pocket.

© 2007 Associated Press.