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Health Care Bill Sparks Debate: Plan for Cutting Insurance Costs is Up for U.S. Senate Discussion Today

Posted on: Tuesday, 9 May 2006, 06:03 CDT

By Jeremy Olson, Pioneer Press, St. Paul, Minn.

May 9--Health care advocates in Minnesota oppose federal legislation that would make insurance more affordable by stripping away state coverage requirements for cancer screenings, maternity care, well-child visits and other routine treatments.

Insurers wouldn't necessarily cease coverage if the mandates were lifted, but opponents fear that the potential cost savings would entice many health plans to eliminate benefits.

"There's a reason why these laws were passed in the states," said Cathy Peters, an American Cancer Society policy researcher. "It's because the market wasn't providing these coverages. We're not real confident that (insurers) would just kind of cover them because it was a good idea."

The proposal (S. 1955) is scheduled for Senate debate today. The House has passed a similar version.

U.S. Sen. Mike Enzi, R-Wyo., sponsored the bill as a way to curb escalating health insurance costs that are forcing many Americans to drop coverage. The bill would, among other things, allow small employers to group together to increase their negotiating leverage with health insurers. The reduction in state mandates could reduce operating costs for insurers.

Supporting Enzi is a consultant's report suggesting the bill would lower small-business health insurance costs by 12 percent and decrease the uninsured rate among working families by 8 percent.

"One family shoe store can't get an insurance company to play ball," Enzi said earlier this spring. "But 10,000 family shoe stores probably can."

In Minnesota, state laws regulate coverage of bone marrow transplants, diabetic supplies, cervical cancer screening, anti-psychotic drugs, mental health treatment and maternity care, among others.

Minnesota Attorney General Mike Hatch warned Enzi in an April 6 letter that the loss of these mandates would cause a "race to the bottom" in which insurers eliminate benefits. Other state attorneys general have joined the opposition.

"The irony is his proposal will undoubtedly result in less health insurance coverage," Hatch said.

Leaders of the AARP and the cancer society said Monday the bill might expand coverage but will give people watered-down benefits.

"We need health coverage for everyone, but not a cosmetic approach where we say, 'Well, we've got health coverage,' but we really don't," said Shirley Hunt Alexander, a breast cancer survivor from Edina who spoke on behalf of AARP. She said a mammography exam (and coverage of the screening) saved her life.

The focus on mandates doesn't affect most Minnesotans because they don't apply to employers who self-fund their health plans. Six of 10 Minnesotans with private insurance are in self-funded plans, according to the Minnesota Council of Health Plans.

Minnesota health plans probably wouldn't change much if the mandates were lifted, said Dannette Coleman, vice president for public policy for Medica, a private insurer. While some small employers might seek affordable plans with reduced benefits, she said, it wouldn't be good business for Medica to slash desired benefits such as maternity care from its standard offerings.

The state allowed insurers last year to create mandate-free plans, she noted. None of the insurers created such plans.

Jeremy Olson can be reached at jolson@pioneerpress.com or 651-228-5583.

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Copyright (c) 2006, Pioneer Press, St. Paul, Minn.

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Source: Saint Paul Pioneer Press (St. Paul, Minn.)

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