Legislature(2007 - 2008)

05/10/2007 01:36 PM Senate L&C


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         SB 170-INSURANCE COVERAGE FOR WELL-BABY EXAMS                                                                      
                                                                                                                              
CHAIR ELLIS announced the consideration of SB 170.                                                                              
                                                                                                                                
1:39:23 PM                                                                                                                    
MARIT CARLSON-VAN DORT,  staff to Senator McGuire,  sponsor of SB
170,  explained  that  this bill  would  require  private  health                                                               
insurance  plans to  cover well-baby  exam  coverage for  infants                                                               
during their first  24-months of life in  their standard coverage                                                               
for  dependents.  These  exams   are  considered  to  be  routine                                                               
pediatric health  care and generally  each visit costs  from $125                                                               
to $250,  not including immunizations. These  exams would include                                                               
monitoring   development  and   growth  rate,   hearing,  vision,                                                               
language   skills,   motor    development,   diet   and   general                                                               
preventative  health care  as well  as infectious  diseases. They                                                               
would  provide a  cost effective  way  to insure  a child's  good                                                               
health  by preventative  intervention, as  opposed to  addressing                                                               
the child when he  is in the ER and very sick  with a high fever.                                                               
Twenty-one  other states  require commercial  insurance companies                                                               
to cover some level of well-child care.                                                                                         
                                                                                                                                
SENATOR STEVENS remarked  that someone would have to  pay for the                                                               
exams.                                                                                                                          
                                                                                                                                
MS. VAN DORT replied that the  cost of these exams would be borne                                                               
by the insurance  companies who might or might not  pass it on to                                                               
consumers through higher premiums.                                                                                              
                                                                                                                                
SENATOR STEVENS asked how much they would cost.                                                                                 
                                                                                                                                
MS. VAN DORT  replied somewhere around $1,500 for  six visits per                                                               
year.                                                                                                                           
                                                                                                                                
CHAIR ELLIS noted  that committee members now have  a CS, version                                                               
C.                                                                                                                              
                                                                                                                                
MS. VAN  DORT explained that the  CS deletes language on  page 1,                                                               
lines  10-11, that  limits coverage  to  $1,500 a  year for  each                                                               
covered baby. The sponsor did not  want to unduly mandate a limit                                                               
which may or may not already exist with the insurance carrier.                                                                  
                                                                                                                                
CHAIR  ELLIS said  they would  hold off  consideration of  the CS                                                               
until they received further testimony.                                                                                          
                                                                                                                                
1:44:08 PM                                                                                                                    
STEPHANIE BIRCH, Section Chief,  Women & Children, Family Health,                                                               
Division, Department  of Health and Social  Services (DHSS), said                                                               
she has a  master's degree in Public Health and  explained that a                                                               
foundation  of  periodic and  regular  visits  to a  health  care                                                               
provider  during the  first two  years of  life is  more commonly                                                               
termed as "health supervision." The  focus of these visits is not                                                               
just  prevention  or treating  illness  or  injury, but  activity                                                               
promoting the  physical, emotional, mental and  social well-being                                                               
of children and their new parents.                                                                                              
                                                                                                                                
MS.  BIRCH said  the  American Academy  of Pediatrics  recommends                                                               
that new-borns through  age 2 receive a total of  10 visits, with                                                               
7 of them  occurring in the first year of  life. This schedule of                                                               
visits  reflects the  anticipated  developmental milestones  that                                                               
most children will demonstrate at a  given period of time as they                                                               
mature.  In  addition, many  of  the  scheduled visits  occur  in                                                               
coordination with the recommended immunization schedules.                                                                       
                                                                                                                                
She explained that health supervision  visits generally include a                                                               
health  interview or  history,  an assessment  by  a health  care                                                               
provider of  the physiological,  emotional, cognitive  and social                                                               
development which  also includes developmental  milestones. There                                                               
is also  observation of the parent/child  interaction, a physical                                                               
exam from  head to toe,  screening procedures, and  an evaluation                                                               
of strength and issues within  the parent/child relationship. The                                                               
intent is for  parents to participate as full  partners in health                                                               
supervision visits.                                                                                                             
                                                                                                                                
She  said   that  families   who  establish   long-term  trusting                                                               
relationships  with  a  primary  health  care  provider  tend  to                                                               
receive  continuous,  coordinated  and comprehensive  care.  Many                                                               
studies  have  shown that  children  in  a medical  home  utilize                                                               
emergency rooms  less often, have  less of a tendency  to doctor-                                                               
shop  and are  less  likely  to have  issues  of  child abuse  or                                                               
neglect. In  addition, developmental  lags are much  more quickly                                                               
identified and children  can be referred in  a more-timely manner                                                               
for community based or specialty services.                                                                                      
                                                                                                                                
MS. BIRCH  concluded saying that  the DHSS supported  the essence                                                               
of SB  170 as  it will  set a pattern  for regular  screening and                                                               
assessments  and assist  in establishing  a  relationship with  a                                                               
consistent health care provider.                                                                                                
                                                                                                                                
1:45:55 PM                                                                                                                    
SENATOR BUNDE joined the committee.                                                                                             
                                                                                                                                
1:47:56 PM                                                                                                                    
SENATOR STEVENS  asked Senator McGuire  how much the  exams would                                                               
cost and who would pay for them.                                                                                                
                                                                                                                                
SENATOR MCGUIRE, sponsor  of SB 170, responded  that most private                                                               
health  care providers  already  offer well-baby  exams and  this                                                               
bill tries  to catch those that  may not. It recognizes  that the                                                               
cost of a sick  baby is much higher than the cost  of the exams -                                                               
therefore  representing   a  net  gain  to   both  the  insurance                                                               
recipient and the insurance pool. An  exam for her own baby costs                                                               
$110 and  she noted  that one  can't put a  child in  a state-run                                                               
school system without their inoculations.                                                                                       
                                                                                                                                
CHAIR ELLIS asked her to explain why she eliminated the cap.                                                                    
                                                                                                                                
SENATOR MCGUIRE  responded that the  director of the  Division of                                                               
Insurance,  Linda Hall,  said that  some companies  already cover                                                               
more than what  this bill requires and she did  not want to limit                                                               
that coverage.                                                                                                                  
                                                                                                                                
1:53:27 PM                                                                                                                    
SENATOR BUNDE  asked if  the state  health plan  covers well-baby                                                               
exams.                                                                                                                          
                                                                                                                                
SENATOR MCGUIRE replied  that the state plan does  not cover them                                                               
now, but she thought it should  and she would welcome a letter of                                                               
intent that any state-administered plan cover well-baby exams.                                                                  
                                                                                                                                
SENATOR BUNDE said it would  seem inconsistent to require private                                                               
enterprises to adopt a standard the state doesn't have.                                                                         
                                                                                                                                
SENATOR MCGUIRE didn't disagree and  said that for the most part,                                                               
private  companies are  already  offering them  -  and she  would                                                               
welcome a  fiscal note. She  believed that well-baby  exams would                                                               
save money in the long run.                                                                                                     
                                                                                                                                
1:57:03 PM                                                                                                                    
SENATOR BUNDE said  that letters of intent often  get ignored and                                                               
he recommended that  the requirement for all plans  be written in                                                               
the bill.                                                                                                                       
                                                                                                                                
SENATOR MCGUIRE agreed.                                                                                                         
                                                                                                                                
SENATOR STEVENS  read a  letter from  the National  Federation of                                                               
Independent  Businessmen calling  this  an  unfunded mandate  and                                                               
saying that it should be  handled in discussions between employer                                                               
and employees.                                                                                                                  
                                                                                                                                
SENATOR  MCGUIRE responded  that you  can expect  those kinds  of                                                               
letters  in  dealing  with  insurance  companies  and  while  she                                                               
respected  their right  to defend  their philosophical  position,                                                               
she  thought  it  sometimes  takes  public  policy  to  encourage                                                               
insurance companies to  do the right thing. "It's  just a common-                                                               
sense provision  that you  know is  going to  pay off  in spades,                                                               
because one  visit to  the emergency  room these  days is  in the                                                               
$30,000 figure." There are places  for those negotiations to take                                                               
place  between  an employer  and  an  employee, but  sometimes  a                                                               
public policy enhances the employees' negotiation position.                                                                     
                                                                                                                                
1:59:48 PM                                                                                                                    
CHAIR ELLIS  turned to the  CS that  eliminated the cap  that has                                                               
the Linda Hall stamp of approval.                                                                                               
                                                                                                                                
SENATOR DAVIS moved  to adopt CSSB 170, version C.  There were no                                                               
objections and it was so ordered.                                                                                               
                                                                                                                                
SENATOR  DAVIS said  she would  take up  the intent  in her  HESS                                                               
committee.                                                                                                                      
                                                                                                                                
2:01:43 PM                                                                                                                    
SENATOR STEVENS said  he sides with business and he  didn't get a                                                               
good answer as to  how much the exams will cost  and who will pay                                                               
for them.                                                                                                                       
                                                                                                                                
2:03:01 PM                                                                                                                    
SENATOR DAVIS said  she understood where he was  coming from, but                                                               
that businesses would  be better off with  the bill. Preventative                                                               
procedures will keep  them from having a larger bill  on down the                                                               
line. This will make all companies pick  the exams up - and it is                                                               
an   issue  that   will  never   be  resolved   if  left   up  to                                                               
employer/employee negotiations.                                                                                                 
                                                                                                                                
2:05:33 PM                                                                                                                    
SENATOR  DAVIS  moved to  pass  CSSB  170(L&C), version  C,  from                                                               
committee  with individual  recommendations  and attached  fiscal                                                               
notes.                                                                                                                          
                                                                                                                                
SENATOR STEVENS objected because they  are looking at raising the                                                               
insurance  cost  to  businesses throughout  the  state  and  this                                                               
committee is the Labor and  Commerce Committee where it should be                                                               
looked at.                                                                                                                      
                                                                                                                                
SENATOR BUNDE said he was still  concerned that the state did not                                                               
offer this coverage.                                                                                                            
                                                                                                                                
A  roll call  vote was  taken. Senators  Bunde, Davis,  and Ellis                                                               
vote yea; Senator  Stevens voted nay; and so  CSSB 170(L&C) moved                                                               
from committee.                                                                                                                 
                                                                                                                                

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