Lawmakers in Washington are not the only ones debating health
reforms. Among the hundreds of bills facing Oklahoma legislators
when they return to the State Capitol Feb. 2 are several proposing
expanded health insurance coverage.
Under House Bill 2808, by Rep. Scott Adkins, R-Broken Arrow,
health insurance and health benefit plans could not prohibit a
physician from waiving all or part of a co-payment for charitable
purposes or if the physician reasonably believes the patient could
not afford the services otherwise.
Dick Howard, Blue Cross/Blue Shield vice president of public
affairs, said this bill could defeat the very purpose of co-payment
requirements -- to discourage unnecessary utilization of health care
Factors such as deductibles and co-payments help keep health
coverage costs in check, he noted. Simply put, if a health insurance
plan has to pay more in benefits due to a lower deductible or waiver
of a co-payment, Howard said rates are necessarily impacted.
Rep. Wallace Collins, D-Norman, has filed House Bill 2947, which
would require group health insurance and health benefit plans to
offer coverage for severe mental illness equal to benefits for other
physical diseases and disorders. The bill defines severe mental
illness as schizophrenia, bipolar disorder, major depression, panic
disorder, obsessive-compulsive disorder and schizoaffective
It allows limitations for pre-existing conditions and exempts
specified-disease policies. The bill is similar to a measure
approved by the Legislature last year but vetoed by the governor,
said it could increase employers' health insurance costs
Howard said the costs associated with the Collins bill would
depend upon whether it covers managed care or traditional group
insurance plans, among other issues. Backers of last year's measure
said it might add about 1 percent to health care costs. A study by
the National Center for Policy Analysis estimated annual additional
costs at between 5 percent and 10 percent.
A measure Howard said, at first glance, that has the potential of
adding more to health coverage costs than any other filed so far
year is House Bill 2981, the Health Care Liability Act by Rep.
Richard Phillips, R-Warr Acres. A "shell" version of this measure
also has been introduced by Rep. Sean Voskuhl, D-Marshall, in House
The bill provides that health care entities have a duty to
exercise ordinary care when making treatment decisions, making them
liable for damages and harm to an insured proximately caused by a
provider's failure to exercise such care.
The bill would extend liability to treatment decisions made by a
health care entity's employees and representatives which result in
the failure to exercise ordinary care. It also would prohibit
removal of a physician or health care provider from a plan for
advocating, on behalf of an enrollee, appropriate and medically
necessary health care.
Howard said a similar measure passed the Texas Legislature last
In addition to the substantial cost of defending lawsuits, Howard
said such a law could have a far-reaching impact on the health care
utilization review process, if plan reviewers know they could be
over the decisions they make.
Another NCPA study estimated legislation holding health plans
liable for the actions of their providers could increase health plan
costs by 4 to 5 percent, while citing Congressional Budget Office
data placing the figure as high as 12 percent. This study attributed
additional increased costs chiefly to the increased practice of what
is termed "defensive medicine" -- that is, health care providers
ordering more tests and procedures than they normally would as a
protective mechanism -- additional liability insurance costs and
increased administrative costs due to the mandate.
Rep. Frank Davis, R-Guthrie, has filed House Bill 2803, which
would require health plans providing pregnancy-related benefits to
extend coverage to diagnosis and treatment of infertility. …