Newspaper article The Christian Science Monitor

States Push to Legislate Managed Health Care Utah's Example

Newspaper article The Christian Science Monitor

States Push to Legislate Managed Health Care Utah's Example

Article excerpt

Utah is drawing a line in the sand on managed health care.

Recently, the Legislature narrowly defeated a bill that would have mandated coverage of mental health in managed-care plans. The bill would have put too great a burden on health-care providers, opponents argued, forcing them to raise prices.

But in Utah and in statehouses across the country, the battle to define what managed-care plans should and shouldn't cover is just heating up. Increasingly, lawmakers are pushing managed-health providers like health-maintenance organizations (HMOs) to include a wider range of people and ailments in their coverage. But the providers counter that this push will nudge their bottom line upward, making care less affordable. As legislators reach their decisions during the coming year, the future of the managed-care system hangs in the balance. "The trend is toward legislator-designed health plans," says Larry Bunkall, president of the Utah Manufacturers Association. Indeed, Utah is at the forefront of the movement, with lawmakers here considering 15 bills that would mandate coverage of everything from dermatology to depression. And Utah's not alone. The Health Insurance Association of America estimates that a hodgepodge of as many as 13,000 benefit requirements have been put in place around the nation - and more are coming. The managed-care conundrum Managed-care programs were created to stem double-digit premium increases while offering quality health care, but they have come under increasing fire for sacrificing quality and choice to keep costs down. Recently, President Clinton made his patient "bill of rights" a key part of his State of the Union address, and a current federal proposal, the Patient Access to Responsible Care Act (PARCA), would allow patients to claim for injury or death resulting from the denial of treatment. Nationally, big businesses that self-insure are having to deal with this rising tide of federal legislation like PARCA. …

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