To hear the health insurance companies tell it, health plans are being nickeled and dimed by the state Legislature this year with a series of bills that would mandate insurance policies to cover various medical procedures. Supporters of the proposals, including Democratic lawmakers and patient-rights groups, say they are simply trying to ensure that patients are covered for routine and common medical procedures when they buy health insurance.
The fight played out over the course of a five-and-a-half hour hearing this week in the Assembly Health Committee, where six of these mandated coverage bills were heard, and passed, by the committee. All of them passed on nearly party-line votes.
At times, the Assembly Health Committee appeared to be running on a hamster wheel, with the same group of advocates offering testimony in support of these bills, and the same cluster of lobbyists from the insurance industry and business groups coming forward to offer their opposition.
One member of the committee, Assemblyman Dave Jones, pointed out that many of the bills, on their own would increase health premium costs by a fraction of one percent. In referencing a bill by Paul Krekorian, D-Glendale, that would increase HIV testing, and would cost health insurers about $500,000 statewide.
""My analysis says it's going to increase premiums by .0007 percent," Jones said of the Krekorian bills. Jones noted that with all of the mandated coverage bills coming up in the hearing, "frankly, I'll be a little more concerned if the number is bigger than .0007 percent."
But the California Association of Health Plans, which represents 40 health plans in California, says as a whole, these bills will help drive up the cost of health insurance and make it more difficult for the uninsured to afford care. "There are a large number of these bills this year," said Nick Louizos, a lobbyist for CAHP. "Some of the cost estimates on these bills vary. There are other bills where the premium impacts are a lot larger. Our industry can't afford this year to look at them at an individual level. We are considering these bills as a package."
Anthony Wright, executive director of Health Access California, a patient-rights group, dismissed Louizos's claim as "whining by the insurers. The truth is that a lot of the specific mandates are really, really small."
According to an analysis being circulated by the health plans, there are 11 coverage mandate bills working their way through the Legislature this year. The analysis claims that these bills will cost insurance providers an additional $2.7 billion annually.
The health plans estimate that if these bills are all signed into law, more than 85,000 will be price d out of the health care market.
Again, Wright was skeptical. "If you actually look at these mandate bills, many of them are in fact bupkis in terms of how much they would impact an actual premium. We're looking at very small things."
The most controversial of these mandate bills is AB 1774 by Assemblywoman Sally Lieber, D-Mountain View. Lieber's measure would force health plans to provide coverage for any screening and diagnosis tests associated with gynecological cancers.
Health plans say Lieber's bill would cost health care providers more than $2 billion, and lead to 82,000 people losing their health care coverage because of rising premium costs.
In her testimony Tuesday, Lieber said health plans were inflating the scope, and the cost, of the bill. "The intent of the bill is to provide screening of at-risk and symptomatic women," Lieber said. "It is not our intent to mandate regular screening for average risk or asymptomatic women."
That did little to mute the opposition from the health plans.
Some committee members did raise concerns about Lieber's bill, and she wound up taking a series of amendments to the bill that would explicitly narrow it's scope. It was unclear what effect, if any, the amendments would have on the health plans' position on the bill.
Among the other coverage mandate bills heard by the committee yesterday was a bill that would expand mental health coverage (AB 1887 by San Jose Democrat Jim Beall); a bill that would provide more coverage for breast cancer screening (AB 2234 by Assemblyman Anthony Portantino, D-La Canada); and a bill to expand coverage of maternity health care (AB 1962 by Hector De La Torre, D-South Gate, which was passed with a Yes vote from Republican Bill Emmerson, R-Redlands).