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.