JEFFERSON CITY _ In the absence of a health package in Gov. Mel Carnahan's program for this legislative session, GOP lawmakers are moving forward with their own plan for expanding access to health care coverage.
But the Republican plan is much less sweeping than the package the governor proposed in the 1994 legislative session. It would not impose the kind of requirements on the medical profession that generated so much opposition from segments of the health-care industry last year.
The governor had proposed last year that health insurance companies provide at least five standard benefits packages to allow consumers to price shop.
The specific contents of each package would have been determined by the Insurance Department.
``We really don't want the Department of Insurance or the government in general involved in this, so we're putting (designing the packages) in the hands of private insurers,'' said Rep. Ronald Keeven, R-St. Louis County. Keeven is co-sponsor of the GOP health bill.
The Republican bill retains the governor's idea to require insurance companies to sell to anyone regardless of prior illness or pre-existing condition. But there are some restrictions.
If the individual is transferring to a policy with a higher coverage, the pre-existing condition would not be covered for six months, Keeven said.
``This just makes it a little more fair for the insurance companies,'' Keeven said.
Under the Republican bill, out-of-pocket medical expenses are tax deductible for those who do not have insurance through their employers. For example, if an individual with a $20,000 income pays $1,000 that year in medical expenses, he or she would only be taxed on $19,000.
But some Democratic lawmakers have voiced reservations about this aspect of the plan.
``I think this bill would be self-defeating if it causes a loss in revenue to the state,'' said Philip Smith, D-Louisiana. Smith is the chairman of the House Science Committee, to which the bill has been assigned.
The tax deduction also was questioned by Rep. Ken Jacob, D-Columbia, who was active in this past session's health-care debate.
``Would that have any impact on employers not providing insurance anymore?'' Jacob said. ``I think that would be a terrible result.''
The Republican plan also would require all Missourians over 18 years old to have health insurance, or they could be fined. If an individual couldn't afford a policy, he or she would apply to the Social Services Department for medical assistance benefits to pay for insurance.
``We've mandated that everyone have car insurance, and health insurance should be the same way,'' said Glen Hall, R-Grain Valley, the bill's co-sponsor. ``Those with health insurance have to pay for those without it. Bringing everyone under the system will reduce costs for the majority of the public.''
With a higher concentration of Republicans in the legislature, some Republicans express hope their approach may have a better chance this year.
``No Republican (health) bill even got a hearing last year, but now we've got that in the first two weeks of the session,'' Keeven said. ``I don't think this bill will be kept from the floor (of the House).''
But the committee chairman was not so sure about committee approval.
Smith said the bill will be ``difficult, if not impossible'' to pass out of committee.
``Like last year's bill, this bill makes a lot of all-encompassing changes,'' Smith said. ``That makes a lot of enemies.''
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