The Edwards Agency


Mandated insurance coverages are not 'peripheral'

mandated benefits Having seen the recent campaign literature of Bill Backlund defending his position on legislation he sponsored, I took the time to download the referenced legislation from the Internet and read it.
   Let's just examine HB-2331, providing a review of mandated health insurance benefits.
   According to the House Bill Report for this legislation, with Backlund as primary sponsor, "Mandated benefits ... were adopted after a period when, as a result of collective bargaining, full benefits packages, including doctors, hospitals, drugs, etc., became common insurance products. Thus, counter to popular belief, mandated benefits do not represent a core benefits package, but rather a peripheral set of specific services and providers that have enjoyed the support of consumers and provider interest groups."
   This bill goes on to identify for review 16 mandated benefits "for the purpose of determining the appropriateness of their continuation," listed in the following order: 1. Mammogram insurance coverage; 2. Reconstructive breast surgery; 3. Mastectomy and lumpectomy insurance coverage; 4. Registered nurse or advanced registered nurse insurance coverage; 5. Dentistry insurance coverage; 6. Temporomandibular joint disorders insurance coverage; 7. Mental health insurance; 8. Psychological services; 9. Chemical dependency insurance; 10. Neurodevelopmental therapy insurance coverage; 11. Phenylketonuria (PKU) insurance coverage; 12. Home Health hospice insurance coverage; 13. Chiropractic insurance coverage; 14. Optometric insurance coverage; 15. Podiatric insurance coverage; and 16. Women's health care provider self referral.
   Ask a woman whose insurance-eligible mammogram led to an early detection of breast cancer if that mammogram is a peripheral service. Ask a woman who has had a radical mastectomy to save her life, if that mastectomy is a peripheral service.
   Ask a physician who is responsibly holding down medical costs for his or her patients by using nurses as appropriate, lower-cost care providers, if coverage of those nursing services is peripheral.
   Ask families who have been able to remain in the workplace while caring for a terminally ill family member because of the supportive services of home health and hospice care, if those are peripheral services.
   Think about it. There are reasons, good reasons, why those services became mandated for health insurers to provide. The only folks I can think of who benefit from their elimination as required coverages are the insurance companies.
   Somehow I doubt the insurers will pass that savings on to us consumers in the form of lower premiums.

Julie Davidson, Woodinville